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HEAD OFFICE

8th Fl, WorldMeridian Venture Center II, 426-5,

Gasan-dong, Geumcheon-gu, Seoul, Korea

Tel. 82-2-2016-7000 Fax. 82-2-2016· 7001

Implant R&D Center

#38-44, Geoje 3-dong, Yeonje-gu, Busan, Korea. Zip. 611-801

Tel. 82-70-7016-4745 Fax. 82-70-4394-0404

[email protected] http://www.osstem.com

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Vol.6

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•• Documentations Vol.6

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IMPLANT

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Contents

Subjective Satisfaction of Clinician and Short-Term Clinical Evaluation of Osstem TSIII SA ImplantJ Korean Cilnical Implant 2010;30(7):430-43

Case Report of Guided Bone Regeneration in Dehiscence-Type Defects Using Hydrophilic Surfaced Implant (TSIII CA) andSMARTbuilderScientific Poster, Osstem Meeting 2013

Preliminary Clinical Evaluation of Customized Three-Dimensional Pre-formed Titanium Mesh for Localized Alveolar BoneRegenerationScientific Poster, Osstem Meeting 2013

Preliminary Study for Hydraulic Sinus Membrane Elevation by CAS KIT without Bone GraftScientific Poster, Osstem Meeting 2013

Prospective Comparative Study of Tapered Implant with SLA Surface at Maxillary Posterior Area According to Loading Time:3 and 6 monthsScientific Poster, 21st Congress of EAO 2012

Sinus Bone Grafting with Simultaneous Implant Placement in Case of Residual Bone Height Less Than 4mm Using TSIII SAImplantScientific Poster, 22nd Congress of EAO 2013

A Case of Rehabilitation of Oral Function with Dental Implants Following Panfacial Bone FractureScientific Poster, Osstem Meeting 2013

Full Mouth Rehabilitation Utilizing the CAD/CAM Technology : Surgical Guide for Flapless Surgery, Provisional Restorationand Screw-Retained Fixed Complete DentureScientific Poster, 21st Congress of EAO 2012

An Implant-Supported Restoration of a Maxillary Central Incisor Using a Temporary Abutment and a Customized CAD/CAMTitanium AbutmentScientific Poster, 21st Congress of EAO 2012

SmartFit Abutment and Custom Healing AbutmentScientific Poster, 21st Congress of EAO 2012

Clinical Comparative Study of Immediate Loading Using Tapered Implant with Hydroxyapatite Coating at the PartialEdentulous Ridge of Posterior Maxilla and MandibleScientific Poster, 21st Congress of EAO 2012

Effect of Microthreads on Removal Torque and Bone-to-Implant Contact: an Experimental Study in Miniature PigsJ Periodontal Implant Sci 2013;43:41-6

Enhancement of in Vitro Osteogenesis to Chemically Activated CA Surface Compared with SA SurfaceScientific Poster, Osstem Meeting 2013

Effect of Photodynamic Therapy on Aggregatibacter Actinomycetemcomitans Attached on Titanium SurfacesScientific Poster, Osstem Meeting 2013

Evaluation of Biomechanical Effect on Chemically Modified CA Surface in VivoScientific Poster, 21st Congress of EAO 2012

Biomechanical and Histomorphometrical Evaluation of Bone-Implant Integration at Sand Blasting with Alumina and AcidEtching (SA) SurfaceScientific Poster, 19th Congress of EAO 2010

Experimental Study of Bone Response to Hydroxyapatite Coating Implants: BIC and Removal Torque TestOral Surg Oral Med Oral Pathol Oral Radiol 2012;114(4):411-8

Comparative Study on the Durability of Abutment Post According to Tightening Torque and Cantilever VolumeScientific Poster, Osstem Meeting 2013

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TS SYSTEMSelected literature of published Journals

■ Clinical Study

■ Pre-Clinical Study

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46A Comparison of Implant Stability Quotients Measured Using Magnetic Resonance Frequency Analysis from Two Directions:Prospective Clinical Study During the Initial Healing PeriodClin Oral Impl Res 2010;21(6):591-7

Non-Submerged Type Implant Stability Analysis During Initial Healing Period by Resonance Frequency AnalysisJ Korean Acad Periodontol 2009;39(3):339-48

Evaluation of Peri-Implant Tissue in Nonsubmerged Dental Implants: A Multicenter Retrospective StudyOral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;108(2):189-95

A Randomized Clinical 1-year Trial Comparing Two Types of Non-Submerged Dental ImplantClin Oral Implants Res 2010 Feb;21(2):228-36

Four-Year Survival Rate of RBM Surface Internal Connection Non-Submerged Implants and the Change of the Peri-ImplantCrestal BoneJ Korean Assoc Maxillofac Plast Reconstr Surg 2009;31(3):237-42

SS SYSTEMSelected literature of published Journals

■ Clinical Study

Influence of Abutment Connections and Plaque Control on the Initial Healing of Prematurely Exposed Implants: An Experimental Study in DogsJ Periodontol 2008;79(6):1070-4

Peri-Implant Bone Reactions at Delayed and Immediately Loaded Implants: An Experimental StudyOral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:144-8

Flapless Implant Surgery: An Experimental StudyOral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:24-8

The Effect of Internal Implant-Abutment Connection and Diameter on Screw LooseningJ Kor Acad Prosthodont 2005;43(3):379-92


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A Multicenter Prospective Study in Type IV Bone of a Single Type of ImplantImplant Dent. 2012 Aug;21(4):330-4

Comparison of Clinical Outcomes of Sinus Bone Graft with Simultaneous Implant Placement: 4-Month and 6-Month FinalProsthetic LoadingOral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Feb;111(2):164-9

Prospective Study of Tapered RBM Surface Implant Stability in the Maxillary Posterior AreaOral Surg Oral Med Oral Pathol Oral Radiol. 2012 Jul;114(1):e19-24

A 1-Year Prospective Clinical Study of Soft Tissue Conditions and Marginal Bone Changes Around Dental Implants AfterFlapless Implant SurgeryOral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Jan;111(1):41-6

A Relaxed Implant Bed: Implants Placed After Two Weeks of Osteotomy with Immediate Loading: A One Year Clinical TrialJ Oral Implantol. 2012 Apr;38(2):155-64

Evaluation of Sinus Bone Resorption and Marginal Bone Loss After Sinus Bone Grafting and Implant PlacementOral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e21-8

Evaluation of Peri-implant Tissue Response According to the Presence of Keratinized MucosaOral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e24-8

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GS SYSTEMSelected literature of published Journals

■ Clinical Study

Morphogenesis of the Peri-Implant Mucosa: A Comparison Between Flap and Flapless Procedures in the Canine MandibleOral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:66-70

Influence of Premature Exposure of Implants on Early Crestal Bone Loss: An Experimental Study in DogsOral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:702-6

Microleakage of Different Sealing Materials in Acess Holes of Internal Connection Implant SystemsJ Prosthet Dent 2012;108:173-180

Fatigue Characteristics of Five Types of Implant-Abutment Joint DesignsMet Master Int 2008;14(2):133-8

The Effect of Various Thread Designs on the Initial Stability of Taper ImplantsJ Adv Prosthodont 2009;1:19-25


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Success Rate and Marginal Bone Loss of Osstem USII Plus Implants: Short Term Clinical StudyJ Korean Acad Prosthodont 2011;49(3):206-13

The Study of Bone Density Assessment on Dental Implant SitesJ Korean Assoc Oral Maxillofac Surg 2010;36(5):417-22

A Retrospective Evaluation of Implant Installation with Maxillary Sinus Augmentation by Lateral Window TechniqueJ Korean Assoc Maxillofac Plast Reconstr Surg 2008;30(5):457-64

Multicenter Retrospective Clinical Study of Osstem USII Implant System in Type IV BoneJ Korean Implantology(KAOMI) 2007;11(3):22-9

Multicenter Retrospective Clinical Study of Osstem USII Implant System in Complete Edentulous PatientsJ Korean Implantology(KAOMI) 2007;11(3):12-21

Retrospective Multicenter Cohort Study of the Clinical Performance of 2-Stage Implants in South Korean PopulationsInt J Oral & Maxillof Implants 2006;21(5):785-8

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US SystemSelected literature of published Journals

■ Clinical Study

The Effects of Surface Roughness on the Sandblasted with Large Grit Alumina and Acid Etched Surface Treatment: In VivoEvaluationScientific Poster, 20th Congress of EAO 2011

Effects of Different Depths of Gap on Healing of Surgically Created Coronal Defects Around Implants in Dogs: A Pilot StudyJ Periodontol 2008;79(2):355-61

The Effect of Surface Treatment of the Cervical Area of Implant on Bone Regeneration in Mini-PigJ Korean Assoc Oral Maxillofac Surg 2008;34:285-92

Comparison of Push-in Versus Pull-out Tests on Bone-Implant Interfaces of Rabbit Tibia Dental Implant Healing ModelClin Implant Dent Res 2013;15(3):460-9

Quantatitive Biomechanical Analysis of the Influence of the Cortical Bone and Implant Length on Primary StabilityClin Oral Impl Res 2013;23(10):1193-7

Heat Transfer to the Implant-Bone Interface During Preparation of Zirconia/Alumina Complex AbutmentInt J Oral Maxillofac Implants 2009;24:679-83

Fatigue Fracture of Different Dental Implant System Under Cyclic LoadingJ Kor Acad Prosthodont 2009;47:424-34

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Multicentric Retrospective Clinical Study on the Clinical Application of Mini Implant SystemJ Korean Assoc Oral Maxillofac Surg 2010;36(4):325-30

Clinical Research of Immediate Restoration Implant with Mini-Implants in Edentulous SpaceHua Xi Kou Qiang Yi Xue Za Zhi 2010 Aug;28(4):412-6

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MS SYSTEMSelected literature of published Journals

■ Clinical Study

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ObjectiveRecently Osstem implant released a new product line, TSIII SA,which is processed by sand blasting using alumina and acid-etching. This new implant features a tapered design, with anopen thread equipped on top to minimize necrosis of thealveolar bone, while its helix cutting edge allows self-tappingand easy adjustment of the installation direction. The apex isdesigned to improve probing ability into the bone tissue, andfixing ability on the bottom. The manufacturer explains thebenefits of the TSIII SA as follows: 1) Excellent initial stability after loading on bone of poor quality 2) Possibility of early or immediate loading3) Short time required for the procedure4) Easy adjustment of cutting ability and depth5) Easy correction of the installation directionTherefore, the authors investigated the clinical benefits of thisbrand-new implant by evaluating the subjective satisfaction ofclinicians and the short-term clinical outcome after theinstallation of TSIII SA implants in 41 medical centers that areactively involved with dental implantation nationwide, and weare reporting the results.

Materials & MethodsA total of 41 dental clinics took part in this study. 51% of thecenters used the GS system from Osstem implant and 49%used implants from different manufacturers. In total, 522 TSIIIimplants were installed for three months from 31 August toNovember 2009. Maxillary and mandibular posterior regionswere the most frequently implanted areas, and prosthodontictreatments were carried out 3 to 4 months after theinstallation regardless of the installation region. 262 caseswere completed with prosthodontic treatment uponcompletion of the study with the recovery of thequestionnaires.The questionnaire consisted of the following questions. Usersfrom 41 centers completed the questionnaire based on theircombined experience of 522 implantations.(1) Bone quality Bone quality was classified into hard, normal,

or soft bone according to the cl inician’s personalevaluation.

(2) How easy was it to secure the initial fixation?(3) How effective was the cutting ability of the implant into the

bone tissue?(4) Clinician’s compliance with the implantation procedure(5) Failure of the implantation in the early stage and the

bone’s response(6) Overall satisfaction with TSIII and other opinions

ResultsIn this study, the TSIII SA implant was used in settings withvarious degrees of bone quality, and the success rate ofimplantation in the early stage was as high as 99.6%. The TSIIISA implant also showed excellent bone response, and thetreatment period - from installation to prosthetic loading - wasshortened by an average of 3-4 months. No significant differencewas observed in initial fixing force and self-tapping ability, whichindicates that the TSIII SA implants are no different to taperedimplants in terms of their functionality. The compliance evaluation revealed that most of the clinicians donot follow the procedure as specified by the manufacturers.Notably, a relatively high percentage of clinicians did not use acortical drill during normal bone implantation due to the change inthe design of the TSIII system to a single thread type. However,the use of a cortical drill is recommended because torqueinstallation can deviate from the proper range in many cases.When a tapered implant is installed without using countersinkingor cortical drilling in a cortical bone, the chances of excess torqueoccurring are higher, which can result in alveolar bone absorptionduring the healing process. It is notable that 50% of the clinicians answered that there is nodifference between the TSIII SA and previously preferredproducts in the overall satisfaction survey, while 25% of cliniciansresponded that they would wait and see before actuallypurchasing it for clinical application. Though the TSIII SA implantshowed better results in the stimulation of initial bone conductionand bone response, most clinicians stated that they do notperceive any significant difference between the TSIII SA andprevious models in terms of the design; as such, a long-termclinical evaluation of its short history since its commercial releasewill be necessary.

Conclusions 1. A total of 522 implants were installed, 99.6% (n=520/522) of

which were successful. Most of the clinicians evaluated thatthe TSIII SA implants exhibited excellent bone response.

2. About 50% of the clinicians answered that there was nosignificant difference between the TSIII SA and previouslypreferred products in terms of self-tapping ability and initialfixation.

3. The average treatment period was 3.9 months for the maxillar,and 3.4 months for the mandibular, which suggests that theTSIII SA implants can shorten the treatment period.

4. Overall satisfaction with the TSIII SA was rather high, butapproximately 50% of the clinicians answered that there wasno difference in terms of the satisfaction they felt with the TSIIISA compared to previously preferred products.

Subjective Satisfaction of Clinician and Short-Term Clinical Evaluation of Osstem TSIII SA Implant

ObjectiveMost recently, Osstem implant introduced a TSIII CA implant, achemically modified sand-blasted, large grit and acid-etchedtitanium surface implant, in order to enhance bone apposition. Itmight be hypothesized that the hydrophilic properties of TSIIICA implant surfaces may have a higher potential to supportosseointegration in dehiscence-type defects.So, I would like to report the GBR case in dehiscence-typedefects using hydrophilic surfaced implant (TSIII CA) andSMARTbuilder.

Why hydrophilic surface in GBR ?

ConclusionsThree important factors for bone regeneration are spacemaking, presence of blood clot and cells (osteoblasts).The hydrophilic properties of TSIII CA implant surfaces may playan important role in blood clot stabilization and cell (osteoblast)affinity. SMARTbuilder has excellent mechanical properties forstabilization of bone graft materials. Its rigidity prevents contourcollapse, its elasticity prevents mucosa compression, and itsstability prevents graft displacement. Thereby, an essentialprerequisite for bone graft integration, ie, mechanical graftstability, could be guaranteed by SMARTbuilder. So, it might be hypothesized that hydrophilic surfaced TSIII CAimplant and SMARTbuilder are the best combination forsuccessful bone regeneration in dehiscence-type defect

Study design (Case Report)�Age / Sex : 55Y / M �Chief complain : #34, 35, 36 Missing�Past medical history : N / S�Past dental history

- #34 Extraction d / t chronic periodontitis 2 months ago�Treatment plan

- #34, 35, 36 implant placement- #34 GBR d / t buccal bone defect

Case Report of Guided Bone Regeneration in Dehiscence-Type Defects Using Hydrophilic Surfaced Implant (TSIII CA) and SMARTbuilder

NanoTiteCollapsed Clot

Fig. 1~3. Pre-operative radiograph & Intra-operative view

Fig. 4~6. Full thickness mucoperiosteal flap was elevated with crestal incision andone vertical incision on the buccal side of the residual alveolar ridgemesially. Buccal bone defect of #34 extraction socket was observed.TSIII CA implant 4.0x11.5mm was installed at #34 extraction socket.Insertion torque was 30NCm and ISQ value was 71.

Fig. 7~9. B-Oss was soaked with normal saline and SMARTbuilder (2 wallaugmentation)was trimmed with Iris scissors. B-Oss was grafted on theexposed TSIII CA implant and SMARTbuilder was placed. Healingabutment for SMARTbuilder was connected. The mucoperiosteal flap was closed using 4-0 Blue Nylon.

Fig. 10~12. Post-operative radiographIt was observed that bone graft material was well maintained underSMARTbuilder. In addition, the contour of bone graft was also wellmaintained because of the rigidity of SMARTbuilder.

Fig. 22~24. Final prosthetic treatment was done 16 weeks after implantplacement. Gingival condition around implants looks healthy.

Fig. 13~21. 2nd-operative radiograph & Intra-operative view 2nd stage surgery was done 14 weeks after implant placement. Duringthe healing period, SMARTbuilder was not exposed. Mucoperiostealflap was elevated with crestal incision and SMARTbuilder wasremoved. Bone regeneration around the TSIII CA implant wasobserved. Healing abutment (5x5mm) was connected and themucoperiosteal flap was closed using 4-0 Blue Nylon.

a) Situation at 3 min.b) Situation at 5 min.

TSIII SA Collapsed ClotTSIII CA Stabilized Clot

SLActiveStabilized Clot

THREE Important Factorsfor Bone Regeneration

SLACollapsed Clot

SLActiveStabilized Clot

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ObjectiveThe purpose of this preliminary study is to evaluate the ability of customizedthree-dimensional titanium mesh (SMARTbuilder, Osstem, Korea) as a barriermembrane through investigation of clinical implant success rates andcomplications including crestal bone maintenance in application for localizedalveolar bone regeneration.

Materials & Methods1. Patient selectionIn a total of 8 patients, dental implants (TSIII CA, Osstem, Korea) wereplaced and SMARTbuilder, height, healing abutment or cover cap wereapplied for bone regeneration simultaneously (Table 1).

2. Surgical techniqueAutogenous bone, which was harvested by Autobone Collector (Osstem,Korea) (Fig. 1) and mixed with allograft (Sure-Oss, HansBiomed co., Korea) 1: 1 in volumetric ratio, was used as graft material (Fig. 2).

DiscussionSeveral benefits of the use of titanium mesh have been suggested. Titaniummesh provides superior space maintenance, a fundamental prerequisite forany bone regeneration procedure. Furthermore, the pores within the titaniummesh are thought to play a critical role in maintaining blood supply to agrafted defect.Previous studies have suggested that a barrier membrane can exclude theingress of blood supply to a grafted defect, resulting in flap dehiscence andmembrane exposure. Furthermore, Expanded polytetrafluoroethylene(ePTFE) membranes must be removed if flap dehiscence and exposureoccurs to prevent infection, because exposure in these cases will not healspontaneously.Titanium mesh, in contrast, when exposed, might not require immediateremoval, because this material does not interfere with the blood flow to theunderlying tissues owing to the presence of pores within the mesh. The sizeof these pores could be a significant factor because small pores could blockthe integral vascularization process. Another advantage of titanium mesh isthat it provides the most extensive space maintenance of all availablematerials. This results from the great plasticity of the material, which permitsbending, contouring, and adaptation of the mesh to any unique bony defect.The result is the establishment of a defined space below the mesh thatmimics the shape of the desired alveolar ridge.

ConclusionsSMARTbuilder showed the feasibility as the barrier membrane maximizingthe merit of the existing titanium mesh, especially with the ease of applicationand removal during the augmentation procedures for localized alveolar bonedefect.

Results

SMARTbuilder was applied as a barrier membrane (Fig. 3).As seen on the Fig. 4, SMARTbuilder provided the space maintenance.During healing period, SMARTbuilder cover cap was exposed (Fig. 5) andafter 4 months from the operation, SMARTbuilder was removed (Fig. 6). Newbone augmentation was achieved on the labial dehiscence (Fig. 7).After uncovering operation, prosthetic procedure was performed. Thecomplication and success rate were investigated until 6 months after thedelivery of the definite prostheses.

Preliminary Clinical Evaluation of Customized Three-Dimensional Pre-formed Titanium Mesh for Localized Alveolar Bone Regeneration

Fig. 4. SMARTbuilderFig. 3. Post operative periapical film

*Complications are cap exposure with wound dehiscence

Table 1. Overview of patients and surgical records

Patient number

sex ageSurgical

siteimplant Height

Cap /Healing

Complications* SMARTbuilder

1 M 39 #13 4.0X13 III 7X9X7 4X2 H -

2 M 87 #46 4.5X10 II 10X12X7 4X1 C +

3 M 59 #12 4.0X10 II 10X12X9 4X1 C +

4 M 73 #15 4.0X11.5 III 10X12X7 4X2 H -

5 F 64 #15 4.0X10 I 4X8X7 4X1 H -

6 F 54 #45 4.5X8.5 II 10X12X9 4X2 C +

7 F 17 #21 4.0X10 I 4X10X9 4X1 C -

8 M 52 #16 4.5X8.5 III 10X12X9 4X2 H -

Fig. 1. Autogenous bone harvest Fig. 2. Bone graft

Fig. 7. Bone regeneration Fig. 8. Postoperative 4 months

ObjectiveThe purpose of this preliminary study is to investigate the feasibility of no bone graft inmaxillary sinus elevation during the implant treatment and to evaluate the amount ofbone formation under a sinus membrane tented with implants and filled with saline orvenous blood as a graft material in edentulous area of maxillary posterior. Instead oflateral approach, CAS KIT (Osstem, Korea), which is famous for hydraulic sinusmembrane elevation via crestal approach, is utilized in this study.

Materials & MethodsIn a patient with the posterior maxillary edentulism, the placement of dental implants,hydraulic sinus membrane elevation via crestal approach by CAS KIT, and saline orvenous blood filling for space maintenance were performed (Fig 1).Their residual alveolar bone height (RBH) was over 5 mm and the length of dentalimplants was selected as near doubled RBH. Periapical and panoramic radiographs,including cone-beam computed tomography (CT), which were taken preoperatively (T0),and at postoperative 1 months (T1), 6 months (T2), and 12 months (T3), were used toevaluate the bone formation in the maxillary sinus floor.

There were no signs or symptoms of infection or maxillary sinus disease.Thirty-fiveimplants in lengths of 8.5 to 11.5 mm were placed, with an average RBH of 6.8 mm(range 5-9 mm). All the implants remained clinically stable during the study period.Comparison of pre- and postoperative radiographs clearly demonstrated boneformation within the compartment created by the sinus elevation procedure, however,slight drooping of the sinus membrane was observed in all the cases.

ResultsThe study population comprised 20 patients, 11 men and 9 women, ranging from 27 to70 years in age (mean age, 45 years). Sinus lift procedures were performed by CASKIT with implant placement simultaneously. Saline or venous blood filling for spacemaintenance were performed in each 10 cases. No significant complications wereobserved in any of the patients during the healing period, except for physiologic swellingafter surgery. In a total 35 implants (TSIII CA, Osstem, Korea), 14 implants were insertedat premolar areas and 21 implants at molar areas. Of these implants, 3 were TSIII CA4.0mm x 10mm,7 were TSIII 4.0 x 11.5mm, 1 was TSIII 4.5mm x 8.5mm, 3 were TSIII4.5mm x 10mm, 16 were 4.5 x 11.5mm,1 was TSIII 5.0mm x 10mm, and 3 were5.0mm x 10mm (Table 1).

Preliminary Study for Hydraulic Sinus Membrane Elevation by CAS KIT without Bone Graft

*S; saline, V; patient’s venous blood

Mean ± S.D. *significant difference at P < 0.05, �significant difference at P < 0.01

45.6 ± 14.0 6.8 ± 1.2

Table 1. Basic data for this prospective clinical study

Casenumber

Age(yr)

Sex(M/F)

Implant position

Residual bone height (mm)

Filling material*

Implant placed

1 54 M #16 5.4 TSIII CA 4.5X10 S #17 5.3 TSIII CA 4.5X10

2 60 F #15 6.0 TSIII CA 4.5X11.5 V 3 51 M #25 7.1 TSIII CA 5.0X11.5 S

#26 7.4 TSIII CA 4.5X11.5 #27 7.3 TSIII CA 4.5X11.5

4 29 M #16 9.0 TSIII CA 4.5 X11.5 V 5 70 F #25 8.1 TSIII CA 4.5X11.5 V 6 35 F #26 8.4 TSIII CA 4.5X11.5 S 7 28 M #14 5.4 TSIII CA 4.0X10 S

#15 5.5 TSIII CA 4.0X10 8 50 F #27 8.0 TSIII CA 4.5X11.5 S 9 61 M #17 8.5 TSIII CA 5.0X11.5 V 10 35 F #16 6.1 TSIII CA 4.5X11.5 S

#17 6.4 TSIII CA 4.5X11.5 11 33 M #24 7.8 TSIII CA 4.0X11.5 V


12 27 M #15 7.1 TSIII CA 4.0X11.5 S #16 7.4 TSIII CA 4.5X11.5 #17 7.0 TSIII CA 4.5X11.5

13 59 F #26 5.1 TSIII CA 5.0X10 S 14 61 F #15 6.0 TSIII CA 4.0X11.5 S

#16 6.3 TSIII CA 4.5X11.5 15 66 M #24 7.9 TSIII CA 4.0X11.5 V


16 29 F #27 5.9 TSIII CA 5.0X11.5 V 17 36 F #15 5.5 TSIII CA 4.0X10 V

#16 5.5 TSIII CA 4.5X10 #17 6.0 TSIII CA 4.5X11.5

18 41 M #27 6.3 TSIII CA 4.5X11.5 V 19 47 M #24 6.9 TSIII CA 4.0X11.5 V 20 39 M #25 5.0 TSIII CA 4.5X8.5 S

#26 5.2 TSIII CA 4.5X10

Table 2. Measurement of average residual alveolar bone height (RBH)

Alveolar bone height (n=35) Gain of alveolar bone height (mm)

T0 6.8 ± 1.2 Immediate PostOP 14.1 ± 2.5 7.2 ± 1.8*

T1 11.9 ± 2.9 5.1 ± 2.2* T2 10.0 ± 1.8 3.1 ± 1.6�T3 8.9 ± 2.1 2.0 ± 1.9�

Fig. 1. Lift membrane using hydraulic lift system

Fig 3. Schematic drawing showing the measurement of intra-sinus newly formed bonelevel in the maxillary sinus as measured in CBCT over time(*significant difference at P < 0.05)

Fig. 2. Staged CBCT image (coronal view)(a) preperative (T0), (b) immediate postperative, (c) postoperative 12months (T3)

(a) (b) (c)

Fig. 5. Postoperative 4 months Fig. 6. Membrane removal atpostoperative 4 months

ConclusionsMaxillary sinus membrane elevation with the simultaneous placement of implants without theuse of any additional grafting material resulted in intra sinus hard tissue formation around theimplants for a follow-up period of up to 12 months. According to our observations, filling ofperipheral venous blood instead of a graft material can be a more viable alternative to bonesubstitutes and safely used in maxillary sinus augmentation than filling of saline. New boneformation was verified by the stabilization of the elevated sinus membrane from thetenting effect of placement of dental implants and clots of venous blood without bonegraft material. Our preliminary study shows that successful bone formation in the sinusfloor by hydraulic sinus membrane elevation using CAS KIT without bone graft.

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ObjectiveThe aim of this study was to evaluate prospective clinicalresults of tapered implants with SLA surface which wasinstalled at maxillary posterior area and loaded 3 months afterimplant placement.

Materials & Methods�Subjects�From November 2009 through September 2010�Implant: TSIII SA (Osstem, Seoul, Korea)�Site: Posterior area, Maxilla�Group classification: Loading time

- Test group (3m): 3 months after placement- Control group (6m): 6 months after placement

ConclusionsWithin this limitation of short-term evaluation, we achievedfavorable clinical results as follows that tapered implants withSLA surface can be used as which is placed at maxillaryposterior area and followed 3-months loading protocol.

�Methods�Hard tissue evaluation:

- Periapical view (6 months, 12 months after loading)- Stability : ISQ (Osstell mentor)

�Soft tissue evaluation: - AG (attached gingiva)- PI (Plaque index)- GI (Gingival index)- PD (Pocket depth): Buccal (B), Mesial (M), Distal (D),

Palatal (P)�Prosthetic evaluation

- Crown - Implant ration (C/I ratio)- Opposite occlusal arch status- Occlusal gap: Controlled by Shimstock (8 ㎛) and Acufilm

(27 ㎛) articulating paper

Results1. Additional Surgical Process

Prospective Comparative Study of Tapered Implant with SLA Surface at Maxillary Posterior Area According to Loading Time: 3 and 6 months

Test group Gain of alveolar bone height (mm)

Patient 18 18

Age 56.5 ± 11.9 61.7 ± 11.2

Implant 35 33

Follow up span 15.17 ± 5.4 14.48 ± 2.7

6 months loaded 12 months loaded

3m 0.2±0.4 mm 0.2±0.3 mm

6m 0.1±0.2 mm 0.2±0.3 mm

1 ~2 Pack1/2~1 Pack 2 Pack~

8 7 1

Subject Information

Table 2. Systemic disease, 80 patients 20 (25%)

Table 3. Smoking status, 80 patients 16 (20%)

Incomplete healingGood Immediate Extraction

124 (10, 8%) 34 (10, 29.4%) 10 (4, 25%)

Table 8. Placement of site conditions (Perforations)

Table 9. Sinus membrane perforations during the operation80 patients 10 (12.5%) / 168 sites 24 (14.2%)

0~1mm 1~2mm 2~3mm 3~4mm

12 (7%) 46 (28%) 61 (37%) 47 (28%)

Table 5. Residual alveolar bone height (mm)

~10Ncm 11~20Ncm 21~30Ncm 30~40Ncm

17(10%) 59 (35%) 83 (49%) 9 (6%)

Table 7. Insertion Torque

Non -Submerged Submerged Normal Soft

13 (8%) 155 (92%) 124 (74%) 44 (26%)

Table 6. Implantation types / Bone Density

Male Female SUM

Patient 48 32 80

Age 54.6± 8.4 59.0 ± 11.1 55.7±9.7 (29y~79y)

Implant 110 58 168

Table 1. Patient & Implant Information

Flapless GBR Sinus liftSinus lift with GBR

Ridge spliting

3m 5 8 6 10 0

6m 7 6 6 5 1

Results

Controlled DM HTNRheumatoid and

depressionProstatic hypertrophy and

hyperlipidemia

6 14 1 1

Table 4. Site distribution

Diameter 4.0 4.5 5.0 6.0 7.0Length 11.5

SUM

#14 1 - - - - 1

#15 4 4 1 1 - 10

#16 - 12 21 5 1 39

#17 - 6 16 7 1 30

#24 2 - - - - 2

#25 4 4 - 2 - 10

#26 - 13 28 4 - 45

#27 - 5 22 4 - 31

SUM 11 44 88 23 2 168

3. Soft Tissue Evaluation

AG PI GIM D

POP

3m 2.1 0.8 0.6 2.7 2.6 2.9 2.5

6m 2.8 0.9 0.5 2.9 3.5 3.1 3.1

2. Hard Tissue Evaluation2-1. Marginal Bone Resorption

Natural teeth Implant Occlusal gap(μ)

3m 23 12 9.1±9.3

6m 28 5 3.2±5.4

4. Prosthetic Evaluation4-1. Opposite Occlusal arch status

5. Success rate

First Operation Second Operation

3m 69.7±8.7 74.3±6.0

6m 67.1±9.9 72.3±6.7

2-2. Stability (ISQ)

Single Prosthetic Splinted Prosthetics

3m 4 31

6m 5 28

4-2. Prosthetic type

3m 6m

1 1.1

3m 6m

1 1.1

< 5mm > 5mm

8 patients 20 sites 2 patients 4 sites

4-3. Crown to Implant ratio

B

ObjectiveSinus bone grafting and implant placement are predictable treatment optionsfor pneumatized maxillary sinus and severely resorbed maxillary posteriorreconstruction. A minimum of 4~5 mm of residual bone height is traditionallyrecommended for the one-stage surgical procedure of sinus bone grafting andimplant placement to ensure initial stability from preexisting residual bone. I would like to report the survival rates of the TSIII SA implants simultaneouslyplaced into grafted maxillary sinus where the residual alveolar bone heightwas less than 4mm.

Materials & Methods�From Jan. 2010 through Sep. 2012�Average follow-up: 15.8±7.1months after the implant placement

(Min. 188 day~Max. 1,003 day)�Implant / Bone graft material: TSIII SA / OssteOss�Site: Posterior maxillary bone deficiency

Residual alveolar bone height 1~4 mm �Medical History: Those with controlled medical conditions

ConclusionsSinus bone grafting with simultaneous implant placement can be used to treatthe atrophic maxilla in patients irrespective of residual bone when carefulsurgical methods and taper designed implants are used. Immediate sinus bonegrafting with simultaneous implant placement can reduce the number ofsurgeries and overall treatment time. Membrane perforation did not have anadverse effect on implant success if the membrane was properly repaired. In this study, even a short period of time, but the cumulative survival rates were99.4% with an average follow-up of 15.8±7.1 months. So, it is concluded that sinus bone grafting with simultaneous implantplacement in case of residual bone height less than 4mm could be consideredas a predictable procedure.

�Time Schedule for Second Surgery and Prosthodontic Treatment2nd stage surgery was performed about 5.57 months (Min. 112 ~ Max. 409day) after implant placement. Marginal bone level, implant mobility, andpresence of fistula were examined. Final impression was taken 1 or 2 weeksafter 2nd stage surgery. In other words, final prosthetic performed about6.23 months (Min. 139 ~ Max. 423 day) after implant placement. All patientswere treated with a fixed implant-supported prosthesis for final restoration.The final tightening torque of abutment was 30Ncm. The screw-retainedporcelain fused metal or gold crown was fabricated for definitive restorations.

Table 10. Cumulative survival rates (Mean F/up 15.8±7.1months)

Survival Fail

167 (99.4%) 1 (0.6%)

�Perforation management - Perforation size<5mm

Sinus Bone Grafting with Simultaneous Implant Placement in Case of Residual Bone Height Less Than 4mm Using TSIII SA Implant

Perforation size>5mm

Bovine collagen membrane (Lyoplant�,B.Braun Surgical GmbH, Germany)was used.

Bovine collagen membrane (Lyoplant�, B.Braun Surgical GmbH ,Germany) wasfixed to sinus medial wall with titaniumpin (TruTACK�, ACE Surgical Supply,USA) to obtain membrane security.

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ObjectivePanfacial fractures involve trauma to mandibular and maxillarbones. It requires a team approach for management andplanned treatment plan. A functional and esthetic rehabilitationwas successfully accomplished by using a partial removabledental prosthesis in the maxilla and Ramus block bone andallogenic bone graft with dental implants to support fixed dentalprosthesis in the mandible.

Study design (Case Report)1. Sex/Age : Male/312. C.C : Panfacial fracture

Missing teeth due to trauma3. Clinical history : Patient was involved in a motor-cycle

collision on september 9, 2011, and pelvic bone fracture,malar and maxillary bones fracture, mandibular symphysisfracture, laceration on tongue and chin. He also hadlaceration on right nasolabial fold, loss of several teeth,alveolar bone fracture.

4. Missing teeth : #11, 21, 22, 34, 33, 32 ,31, 41, 42, 435. Treatment plan : Open reduction and internal fixation on

fracture site. To get a sufficient depth of bone for thedental implants, we decided to use ramus block bone andallogenic bone graft on maxilla and mandible. We plan touse a partial removable denture for the maxilla and insertthe Osstem TS system implants in the mandible.

6. Treatment process

ConclusionsThis clinical report describes the prosthodontics treatment afterthe open reduction of a panfacial fracture. After the operation ofsuch complex traumas, the locations of the fractured segmentsand the occlusion are distorted and present a challenge to us,resulting in problems such as facial deformation, inefficientmastication, and mal-function of the TMJ. In 2013, restorationwas completed with final prosthodontics. In upper jaw, wetreated the patient with removable partial denture because ofthe alveolar bone and tissue deficiency.

A Case of Rehabilitation of Oral Function with Dental Implants Following Panfacial Bone Fracture

Fig.1. Three-dimensional CT and Skull x-ray photo showing panfacial fracture. Maxillaand mandibular teeth were missing.

Fig.2. Postoperative Skull x-ray photo showing open reduction and internal fixation onpanfacial fracture. a) Rt. lateral oblique mandibular x-ray photo b) Mandibular PA view x-ray photoc) Lt. lateral oblique mandibular x-ray photo

Fig.3. Ramus block bone graft and allogenic bone graft on maxilla and mandible.

Fig.5. Metal framework for mandibular implant supported restoration

Fig.6. Intraoral view and Extraoral view photo

Fig.4. A) Panoramic radiograph of block bone graft B) Panoramic radiograph of dental implants after placementC) Panoramic radiograph of dental implants with custom abutmentD) Intraloral view of dental implants with custom abutment

ObjectiveThe ideal treatment planning, accurate placement, and functional restorationof dental implants for the completely edentulous patient can be challenging.Anatomical limitations can make implant location difficult to determine.The use of CT scans and surgical planning software to produce a CAD/CAMsurgical guide, as well as the use of a flapless surgical technique, can makeimplant placement more predictable, safer, and easier for patients.Furthermore, CAD/CAM-guided fabrication of an provisional restoration andscrew-retained definite prosthesis can result in predictable and successfulfull mouth reconstruction.

Study design (Case Report)�Immediate Removable Complete Denture�CAD/CAM Surgical Guide: OsstemGuide�CAD/CAM Provisional restoration�Convertible Abutment, Lateral fixation screw�CAD/CAM full Zirconia prosthesis

ConclusionsThe advantages of this procedure, for the completely edentulous arch, include (1)shorter surgery times, (2) shorter treatment times, (3) less invasive, flapless surgeryand, therefore, less chance of swelling, less pain, and faster healing

Pre-surgical Procedure: Extraction and Immediate Removable Complete Denture

Before extracting the teeth, removablecomplete dentures are prefabricated on

the teeth-removed-stone model.

Prosthetic Procedure : CAD/CAM Provisional Restoration

Lingual-screw-retained PFM bridgefor Maxillary anterior implants

Screw-retained CAD/CAM fullzirconia bridges

Screw-retained full mouth implant rehabilitation Final radiograph

Pre-surgical Procedure: CAD/CAM Planning and Fabrication of Surgical Guide and Surgical Index

Osstem Guide software Planning Program allows for prosthetic guided implantpositioning.

Using the surgical guides and radiographic guide duplications, stone casts are mounted on the semi-adjustable articulator. Then surgical indexes are made on the mounted casts.

CAD/CAM planning for mandible. CAD/CAM planning for maxilla. CAD/CAM manufactured surgical guides. Upper and Lower Surgical Index

Surgical Procedure: Flapless Implantation

Surgical Guide oriented in the mouth using a surgical index fitted to theopposing radiographic duplication and stabilized with anchor screws.

8 fixtures positioned and seated correctly on the sleeve ofsurgical guide.

Minimally invasive guided surgery results in minimal postsurgicaltrauma of periimplant soft tissue.

Flapless Tissue Punch

Precise osteotomy by Osstem Guide 18 implants installed at the time of surgeryHealing Caps screwed intoconvertible abutments

Relining of dentures withsoft tissue conditioner

10 fixtures in maxilla

Installation of Osstem TSIII SA implants Convertible Abutments

2 months after extraction.Patient with upper and lower immediate complete dentures for 2 months of healingperiod. Dentures were used as radiographic guide with radio-opaque markers

randomly positioned at different levels for double CT scan .

Full Mouth Rehabilitation Utilizing the CAD/CAM Technology : Surgical Guide for Flapless Surgery, Provisional Restoration and Screw-Retained Fixed Complete Denture

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ObjectiveMaxillary central incisors play a critical role in esthetics. One of the most difficultfactors for an esthetic implant restoration is the natural profile of the cervicalarea in which the tooth emerges from inside the gingiva. Many proceduresincluding bone augmentation and soft tissue graft have been suggested tosolve this problem. More recently, techniques using CAD/CAM customized abutments are drawingattentions as promising solutions.The author describes a clinical case with a missing upper central tooth restoredusing an Osstem TS Implant and a customized CAD/CAM (Osstem SmartFit)abutment.

Study design (Case Report)�Patient age/sex: 28Y, male�C/C: Teeth fracture due to trauma�Clinical findings

- Crown fracture of maxillary anterior teeth- Root fracture of Lt. central incisor- Apical radiolucency and fistula

�Provisional RestorationA provisional restoration supported by a temporary abutment was placed 10weeks after implant placement.

�Final RestorationA metal-ceramic restoration was fabricated on a stone cast taken directly usingsilicone rubber impression material.

ConclusionsCustomized CAD/CAM abutment system (Osstem SmartFit Abutment) is apromising technique to overcome many shortcomings of conventionalreadymade abutments or manual milling abutments.

�CAD/CAM AbutmentA SmartFit abutment was fabricated with a fixture-level impression and a cast.

�Surgery- #21 tooth was extracted with minimal trauma and the granulation tissue

was removed.- After careful drilling, a TSIII SA implant (4.0X13mm) was installed.- Insertion torque was 25Ncm.- The gap between the implant and the labial alveolar plate was filled with

synthetic bone graft material (biphasic calcium phosphate).- A short healing abutment was connected and a bonded temporary

restoration was placed.

Extraction and curettage Implant placement

An Implant-Supported Restoration of a Maxillary Central Incisor Using a Temporary Abutment and a Customized CAD/CAM Titanium Abutment

Temporary abutment Provisional restoration

Gap filling with synthetic bone Temporary restoration

Abutment connection A new provisional

ObjectiveThe latest CAD/CAM technology for patient-specific abutmentsis now gaining ground on the Korean dental market. Manyimplant companies are introducing CAD/CAM solution forcustomized abutment. With CAD/CAM abutments, the cliniciancan use high-quality, customized abutments with less time andeffort. Fixture placement in undesirable conditions must beovercome with restorative procedures. Usually, in such cases,cast-gold UCLA abutments have been used to makecustomized abutments.Note, however, that cast-gold UCLA abutments have limitationssuch as increased expenses, casting defects, variable qualitydepending on the technician’s experience, and biocompatibility.These limitations will be overcome with SmartFit abutments forOsstem implants to which CAD/CAM technology was applied.Moreover, clinicians can control the emergence profile andsubgingival contour of implant prostheses with customizablehealing abutment. Custom healing abutment can be a newoption for successful implant prosthetics.In this poster, I would like to introduce two clinical cases ofpatient-specific SmartFit abutment and Custom healingabutment.

Study design (Case Report)

ConclusionsSmartFit abutment with Custom healing abutment provides ananatomically optimal emergence profile for implant prosthesis,maximizing long-term aesthetics and function. As the biggest advantages of SmartFit abutment, it overcomesthe limitations of stock abutment and is a useful adjunctive toolfor producing restorations that approximate natural teeth invarious bad conditions.With Custom healing abutment and SmartFit abutment forOsstem implant systems, clinicians can improve profitability byeliminating time and cost that have been spent on making cast-gold UCLA abutments.Furthermore, they provide patients with patient-specific,customized, well-fitting abutment and brings about win-winresults for both clinicians and patients.

SmartFit Abutment and Custom Healing Abutment

Maxillary premolar tooth with retained root was extracted. By using surgical guide, TSIII SA fixture (4X11.5) was placed in #25 missing area.

Fixture-level impression with transfer impression coping was taken very quickly forpreventing slumping of formed soft tissue contour. Subgingival contour was duplicatedin the impression body. And Oval shape subgingival contour over #25 fixture was shownin working model.

Patient-specific SmartFit abutment was manufactured by milling process in the OsstemCAD/CAM Center. By using the transfer jig, delivered abutment was positioned on theworking model and checked. Then provisional restoration was made on the model.

Through a transfer jig, finished SmartFit abutment was positioned onto implant. After the provisional period, the abutment margin was exposed using the retraction cord,and then direct abutment level impression was made.

A Porcelain-veneered metal crown was made as final prosthesis. Emergence profile of#25 final prosthesis is similar to that of adjacent natural tooth restoration.

Periapical radiographs of abutment and final prosthesis.

Customhealing abutment was connected in the fixture. Well-formed, oval-shape subgingival contour was made with soft tissue sculpting usingCustomhealing abutment.

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ObjectiveThe objective of this study was to evaluate the effect ofmicrothreads on removal torque and bone-to-implant contact(BIC).

Materials & MethodsTwelve miniature pigs for each experiment, a total of 24animals, were used. In the removal torque analysis, eachanimal received 2 types of implants in each tibia, which weretreated with sandblasting and acid etching but with orwithout microthreads at the marginal portion. The animalswere sacrificed after 4, 8, or 12 weeks of healing. Eachsubgroup consisted of 4 animals, and the tibias wereextracted and removal torque was measured. In the BICanalysis, each animal received 3 types of implants. Two typesof implants were used for the removal torque test andanother type of implant served as the control. The BICexperiment was conducted in the mandible of the animals.The P1-M1 teeth were extracted, and after a 4-month healingperiod, 3 each of the 2 types of implants were placed, withone type on each side of the mandible, for a total of 6implants per animal. The animals were sacrificed after a 2-, 4-, or 8-week healing period. Each subgroup consisted of 4animals. The mandibles were extracted, specimens wereprocessed, and BIC was analyzed.

Results No significant difference in removal torque value or BIC wasfound between implants with and without microthreads. Theremoval torque value increased between 4 and 8 weeks ofhealing for both types of implants, but there was nosignif icant difference between 8 and 12 weeks. Thepercentage of BIC increased between 2 and 4 weeks for alltypes of implants, but there was no significant differencebetween 4 and 8 weeks.

ConclusionsThe existence of microthreads was not a significant factor inmechanical and histological stability.

Effect of Microthreads on Removal Torque and Bone-to-Implant Contact: an Experimental Study in Miniature Pigs

Group A

Fig. 1. Design of implants used in the experiment.

Fig. 3. Mean and standard deviation of removal torque(Ncm) at each healing period.

Fig. 4. Mean and standard deviation of BIC(%) at each healing period. BIC:bone-to-implant contact.

Fig. 2. Cross section of implant in mandible. A) Implant group A. B) Implant Group B. C)Larger magnification of the marginal portion where the BIC measurement wasperformed.

Group B Group C

Group A

Time (week)

300

250

200

150

100

50

0

Group B

Rem

ova

l to

rque

(Ncm

)

Group A Group B Group C

Time (week)

100

80

60

40

20

04

33.3

46.0

46.9

75.981.1 73.2

75.177.6 78.9

8 12

BIC

(%)

ObjectiveThe aim of this study is to compare the clinical outcome afterthe immediate loading of two types of implants with a hydroxyapatite coat for patients with missing molar teeth.

Materials & Methods* Subject :- Group I : Osstem TSIII HA (Male 12, Female: 15, Total: 27)- Group II : Zimmer (Male 18, Female: 5, Total: 23)- Group I and group II were assigned randomly and operator

was informed about the study group the day of operation- Patients who undertook loading within 48 hours of implant

installation were included in this study

* Implant distribution:- Group I : maxilla 22, mandible 32, total: 54- Group II : maxilla 24, mandible 22, total: 46

* Average Age- Group I : 51.40 (11.30) years- Group II: 49.73 (14.23) years

* Evaluation factor- Marginal bone loss : 1 years after loading- Soft tissue condition around implant- Primary and 2nd implant stability (Osstell Mentor device)

* An Independent T test was conducted to determine thestatistical significance (SPSS program, P-value <0.05).

Results1. There were no implant failures in both group and survival rate

was 100% 12 months after immediate loading. The numberof cases showing the bone loss more than 1 mm was 3 ingroup I, 5 in group II. Implant success rate of group I was94.4%, group II 89.1%.

2. Mean marginal bone loss was 0.06 mm in group I, 0.44 mmin group II after 1 year. Marginal bone loss of group I wassignificantly lower than group II (P < 0.05).

ConclusionsThe marginal bone loss of implant after immediate loading oftwo types of study implants with hydroxy apatite coat inpatients with missing molar teeth was insignificant. And TSIII HAimplant showed more stable result on the aspect of marginalbone status around implant after immediate loading.

4. As implant primary and 2nd stability, There was no significantdifferences between two groups (P > 0.05). And also therewas no significant differences when comparing the each archbetween groups (P > 0.05).

3. There were no significant differences in peri-implant indicessuch calculus, pocket depth, and width of nonkeratinizedmucosa of both groups except plaque index.. Peri-implanttissue condition was stable in both groups.

Clinical Comparative Study of Immediate Loading Using Tapered Implant with Hydroxyapatite Coating at the Partial Edentulous Ridge of Posterior Maxilla and Mandible

Group I(n=54) Group II(n=46) Sig*

1 year 0.063(0.66) 0.44(0.65) *

Table1. Comparison of marginal bone loss

Independent T test, *: P-value<0.05

Group I Group II Sig*

Maxilla 0.32(0.67)(n=22) 0.66(0.74)(n=24) -Mandible -0.12(0.60)(n=32) 0.19(0.42)(n=22) *

Table2. Comparison of marginal bone loss between groups according to site



PI 0.28(0.41) 0.50(0.54) *CI 0.02(0.13) 0.07(0.24) -

SBI 0.24(0.44) 0.29(0.41) -PD(B) 3.13(1.03) 3.28(1.45) -PD(L) 3.13(1.05) 3.31(1.15) -PD(M) 3.54(1.27) 4.00(1.71) -PD(D) 3.56(1.20) 3.52(1.09) -

Attached gingiva(B) 3.48(1.88) 3.39(1.34) -Attached gingiva(L) 1.12(1.39) 1.08(1.37) -

Table3. Comparison of Peri-implant index between groups



1st(BL) 75.93(8.00) 77.43(5.72) -1st(MD) 77.40(6.50) 77.58(6.74) -2nd(BL) 83.32(4.74) 83.04(4.42) -2nd(MD) 84.42(4.70) 83.08(4.26) -

Table6. Comparison of ISQ between Group I and Group II



PI 0.23(0.38) 0.62(0.57) *CI 0.00(0.00) 0.14(0.33) *



Table4. Peri-implant index according to site <maxilla>



PI 0.312(0.44) 0.36(0.49) -CI 0.03(0.17) 0.25(0.42) -



Table5. Peri-implant index according to site <mandible>


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ObjectiveThe aim of study was to evaluate the effect of chemicallysurface modif ication with hydrophi l icity on variousphysiochemical parameters which involved with in vitroosteogenesis.

Materials & Methods1. Preparation of titanium disks

Two types of commercially pure titanium (Grade 3) diskswith12mm in diameter and 1mm in thickness wereprepared.1) SA surface: Hydrophobic surface by Sandblasting with

Al2O3 and and acid etching with HCl/H2SO4

2) CA surface: Super-hydrophi l ic SA by reducingatmospheric carbon contamination and storing in asolution of calcium.

2. Surface characterization and in-vitro evaluationAfter surface treatment, we verified the surface topography,chemical composition and blood-wettability between twosurfaces by SEM, EDS, contact angle measurement. Thebiological efficiency of chemically activated surface isevaluated by various in-vitro tests such as protein adsorption,platelet activity, osteoblastic cell behavior.

Results1. Protein and platelet response on CA is much higher

than SA

ConclusionsIn this study, we verified the chemistry and wettability oftitanium surface were important variables in determiningprotein and osteoblastic cell response. Albumin adsorption,platelet adsorption and activation on chemically activated CAsurface was dramatical ly enhanced compared withhydrophobic SA surface. Also, these super-hydrophilic CAsurface showed higher osteoblastic response such as celladhesion, proliferation, ALP activity, mineralization. Therefore,chemically activated and hydrophilic CA surface may playroles in stimulating the bone formation and ultimatelyenhanced bone-implant contact compared with hydrophobicSA surface.

ConclusionsOur results demonstrate that association of erythrosine and agreen LED, with wavelength 520 ~ 530 nm, light intensity 150mW/cm2, 4.5 J/cm2 was effective in reducing the viability ofA. actinomycetemcomitans attached to RBM and SLAtitanium surfaces in vitro.

Enhancement of in Vitro Osteogenesis to Chemically Activated CA Surface Compared with SA Surface

ObjectivePeri-implantitis is an inflammatory process affecting thetissues around an osseointegrated implant. As the need offinding more safe and proper treatment for peri-implantitisarose, more attention is focused on noninvasivephotodynamic therapy (PDT) in the treatment of peri-implantitis.The purpose of this study is to assess the efficacy of PDTusing erythrosine and green color light emitting diode (LED)l ight source to the biof i lm of Aggregatibacteractinomycetemcomitans attached on resorbable blastedmedia (RBM) and sand blasted, large grit, acid etched (SLA)titanium surface in vitro.

Materials & MethodsA. actinomycetemcomitans ATCC 33384 was cultivated intrypticase soy broth under anaerobic conditions for 72 hours.After incubating, all disks were rinsed twice with phosphatebuffered saline (PBS). RBM and SLA surface of disks wereexamined by scanning electron microscope (SEM, x 10,000, x30,000) used to examine the bacteria attached on titanium disks. RBM and SLA disks were subdivided into four groupsincluding one control group and three test groups (E0, E30,E60) for PDT examination for each surface.

Results

Irradiation source is light emitting diode (Photron Co. Ltd., Seoul,Korea) with a spectrum of emission ranging from 520 ~ 530 ㎚for 30 seconds (150 ㎽/㎠, 4.5 J/㎠). As photosensitizer, 500 ㎕of 20 μM erythrosine was used for 60 seconds. The disks were put into test tube and agitated with PBS andglass bead for 60 seconds. After agitating, 200 ㎕ of solution withdetached bacteria was spread directly on brucella blood agarplates. The plates were incubated in anaerobic conditions onbrucella blood agar plates for 72 hours at 37�C. Survival rate ofbacteria was determined by counting the colony forming units(CFU) after incubation. Additionally, A time-resolved fluorescenceconfocal microscope was used to observe the distribution oflive/dead microorganisms on disk surface.

Effect of Photodynamic Therapy on Aggregatibacter Actinomycetemcomitans Attached on Titanium Surfaces

SA surface CA surface

Immunofluorescent staining of MG63 cells cultured in SA and CA surface

SA surface CA surface

Morphology of MG63 osteoblast-like cell Cell adhesion and Proliferation

2. Hydrophilic CA surface enhances the cell spreadingbehavior.

SA

Protein adhesion Protein adhesion Protein adhesion

CA SA CA SA CA

Alb

umin

ad

sorp

tion,

[OD

]

3. Hydrophilic CA surface accelerate ALP activity andMineralization

SA

ALP activity (7D) Mineralization (14D)

CA SA CA

ALP

Act

ivity

, [7D

, %/단위면적

]

AM

iner

aliz

atio

n [1

4D, %

/단위면적

]

SA CA

Cel

l ad

hesi

on, [

%]

SA CA

Pro

lifer

atio

n, [2

D, %

/ 단위면적

]

Pla

tele

t ad

sorp

tion,

[%]

Pla

tele

t ad

sorp

tion,

[%]

TreatmentRBM

RBM Inner Surface SLA Inner Surface

Control Control

E0 E0

E30 E30

E60 E60

N

TreatmentRBM N

Control No treatment 5

E0 20 μM Erythrosine 60 seconds 5

E30 20 μM Erythrosine 60 seconds + LED light 30 seconds 5


Control No treatment 5

E0 20 μM Erythrosine 60 seconds 5



Fig. 1. Representative scanning electron microscopy images of RBM titanium surfacecovered by A.actinomycetemcomitans (A, B) and after agitating with glass beadsfor 60 seconds (C, D). Compared to the image before processing, larger amountof bacteria was detached from titanium surface. A&C original magnificationx10,000, B&D original magnification x30,000.

Fig. 2. Representative scanning electron microscopy images of SLA titanium surfacecovered by A.actinomycetemcomitans (A, C) and after agitating with glassbeads for 60 seconds (B, D). Compared to the image before processing, largeramount of bacteria was detached from titanium surface. A&C originalmagnification x10,000, B&D original magnification x30,000.

Fig. 3. Scanning electron microscopy images of RBM (A, B) and SLA (C, D) titaniumsurface after PDT applied by erythrosine with LED radiation for 60 seconds.A.actinomycetemcomitans was showed with deformation of outer wall. A&Coriginal magnification x10,000. B&D original magnification x30,000

Fig. 4. Confocal images of A.actinomycetemcomitans grown on RBM and SLAsurfaces. Live bacteria with intact membranes were stained fluorescent greenusing the SYTO9 stain, while dead bacteria with damaged membranes werestained flouresent red using propidium iodide.

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ObjectiveThe aim of the study was to evaluate the effect of chemicallymodified hydrophilic CA surface compared with conventionalSA surface in various animals.

Materials & MethodsA total of 20 implants were divided into two groups. Group 1,implants treated with SA were used as control group. Group2 retained chemically modified hydrophilic CA surface. Allimplants were placed in the tibiae of 3 female New Zealandwhite rabbits and in the mandible of 2 male miniature pigs.Removal torque was measured 16days after placement.

Results In tibiae of rabbit, group 1 had a mean removal torque of 50Ncm versus 72 Ncm for group 2 after 16days of healing time.In mandible of miniature pig, group 1 had a mean removaltorque of 68 Ncm versus 75 Ncm for group 2 after 2 weeksof healing time. Group 2 was measured more stableanchorage than group 1 in both animals.

ConclusionsIt is concluded that modified hydrophilic CA sufaces weremore effective for bio mechanical properties of bone-implantcontact from conventional SA surface in rabbits andminiature pigs.

Evaluation of Biomechanical Effect on Chemically Modified CA Surface in Vivo

Removal torque (After 16 days)

(Group 1)

Fig. 1. The result of Removal torque in tibia of rabbits. Group 2 increased more than40% of mean value compared with group. The sample size for group was 5.

100

80

60

40

20

0(Group 2)

Rem

oval

tor

que

(Ncm

)

Removal torque (After 16 days)

(Group 1)

Fig. 2. The result of Removal torque in mandible of miniature pigs. Group 2 increasedmore than 10% of mean value compared with group. The sample size for groupwas 10.

120

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ObjectiveThe implant surface feature and roughness have beenproposed as a potential factor affecting bone integration andmarginal bone loss. The aim of the present study was toevaluate the difference between SA and RBM surface forosseointegration and marginal bone loss in the mandible ofbeagle dogs.

Materials & MethodsAll mandibular premolars and first molars were extractedbilaterally in 10 beagles. After 8 weeks of extraction, 48implants (22 SA surface implants and 26 RBM surfaceimplants) were implanted in the mandible of beagle dogs.After 12 weeks of healing, the implants were evaluatedmarginal bone levels, histomorphometric analysis andremoval torque. 36 implants were used for the removaltorque test. 12 implants were processed forhistomorphometric analysis. For statistical analysis, t-testswere performed (p < .05).

ResultsThere were no statistically significant differences in relation tohistomorphometric evaluations between RBM and SA surfaces.Marginal bone loss was 0.83 ± 0.51 mm (RBM surface) and0.96 ± 0.43 mm (SA surface). No differences could be observedbetween the two surfaces of implants. After a 12 weeks healingperiod, BIC and BA of SA surface were similar to the RBMsurface. There were no significant differences in the BIC and BAbetween the two groups (p > .05). The mean removal torquevalue was higher for a SA surface (127.2 ± 37.0 Ncm) than for aRBM surface (61.9 ± 34.5 Ncm). The differences between RBMand SA surfaces were significant (p < .001).

ConclusionsIt can be concluded that the SA surface was more effective thanRBM surface in enhancing the biomechanical interlockingbetween the new bone and implant.

Biomechanical and Histomorphometrical Evaluation of Bone-Implant Integration at Sand Blasting with Alumina and Acid Etching (SA) Surface

Fig. 1. SEM micrographs of titanium implant surfaces (a) RBM surface, (b) SA surface.

Fig. 2. Changes in the marginal bone levels of RBM and SA.

Fig. 3. Histomorphometric analysis (BIC and BA).

Fig. 4. Removal torque values (Ncm).

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ObjectiveThe objective of this study was to evaluate the earlyosseointegration of hydroxyapatite (HA) coated implant versusresorbable blast media (RBM) and sand-blasted with aluminaand acid etched (SA) surface tapered implants.

Materials & MethodsTwelve adult male miniature pigs (Medi Kinetics Micropigs,Medi Kinetics Co., Ltd., Korea) were used in this study. Theremoval torque of implants placed in the tibia of miniaturepigs was measured. For implants placed in the mandible,histomorphometric evaluation was performed for theevaluation of the bone-implant contact (BIC) ratio.

Results After 4, 8, and 12 weeks, removal torque values were increased.Among the 3 groups, the HA coated group showed the highestvalue (p < .05). When the HA surface, RBM, and SA surfacegroup were compared at each time point, the HA group showedstatistically significantly high removal torque value (RTV) values (p< .05). At 2 weeks, in comparison with RBM, SA showed an 11% increase, and HA showed a 42 % increase; nonetheless, theywere not statistically significant. At 4 weeks, the BIC ratio of HAwas significantly higher than that of SA (p < .05). Nonetheless,RBM and SA were not significantly different (p > .05). At 8 weeks,the BIC of HA was shown to be significantly higher than RBM orSA (p < .05). Nonetheless, RBM and SA were not significantlydifferent (p > .05).

Conclusions The early osseointegration of HA coated implants was found tobe excellent, and HA coated implants will be available in poorquality bone.

xperimental Study of Bone Response to Hydroxyapatite Coating Implants: BIC and Removal Torque Test

Fig. 1. Removal torque value graph.

Fig. 2. BIC ratio.

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ObjectiveThis study sought to do a comparative evaluation of theabutment post's fatigue life experimentally according to thetightening torque and cantilever volume, thereby emphasizingthe importance of t ightening torque specif ied by themanufacturer and suggesting a guide to designing prosthesiswith excellent long-term stability so that it can be appliedcorrectly to actual clinical cases.

Materials & Methods1. Materials

1) Specification

ConclusionsAs can be seen from the comparative test of fatigue life accordingto the tightening torque and cantilever volume, connecting withtorque beyond or below the manufacturer-specified valueshortens the fatigue life, requiring periodic checks of instrumentsas well as caution during actual use. Moreover, since greatercantilever volume results in shorter fatigue life, occlusal prosthesisshould be considered from the fixture's procedure level. Occlusalstrength and antagonist tooth should also be considered whenmanufacturing the prosthesis to produce one with outstandingfatigue fracture performance.

Results1. Comparative test of fatigue life according to tightening torque

Comparative Study on the Durability of Abutment Post According to Tightening Torque and Cantilever Volume

Part Spec.

Fixture TSII SA Fixture ∅4.0 X 11.5mm

Abutment TS Transfer Abutment ∅5.0, G/H 2mm, H5.5mm

Screw EbonyGold Screw Regular screw

2) Test group VS. control group

2. Test equipments1) Fatigue tester: Instron 88412) Torque Gage: Mark-10’s MGT12

3. Methods

cantilever

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Fatig

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Tightening Torque (Ncm)

Height

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<Fatigue Life_cantilever>

Fatig

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Cantilever (mm)

Tightening TorqueTest SpecCantilever

Test group 20Ncm, 25Ncm, 35Ncm, 40Ncm 6mm, 5mm, 4mm

Control group 30Ncm -

( N= 5 EA)

Moment = X (mm) × Load (N)= L (mm) × sinθ× Load (N)

The picture on the left is a diagram of theweight for the cantilever fatigue test applied tothis test. When cantilever weight was applied,its volume became as important as its weight.The greater the cantilever volume became, thegreater the moment applied by the samplefrom the fixed center, thereby easily causingfatigue fracture due to the repeated weights.

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1. Young-Kyun Kim, Ji-Hyun Bae. Subjective satisfaction of clinician and Short-termClinical Evaluation of Osstem TSIII SA Implant. J KoreanCilnical Implant 2010;30(7):430-43

2. Ki-Seong Kim. Considerations in Using Patient-Specific Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) TitaniumAbutment. Implantology 2013;17(1):2-14

3. Yong-Jin Kim, Young-Jin Park, Kyung-Tae Park. Case report of Guided Bone regeneration in dehiscence-type defects using hydrophilicsurfaced implant(TSIII CA) and SMARTbuilder. Scientific Poster, Osstem Meeting 2013

4. Seung-Hwan Jeon, Kyung-Gyun Hwang, Chang-Joo Park. Preliminary clinical evaluation of customized three-dimensional pre-formedtitanium mesh for localized alveolar bone regeneration. Scientific Poster, Osstem Meeting 2013

5. Kun-Soo Chang, Kyung-gyun Hwang, Chang-Joo Park. Preliminary study for hydraulic sinus membrane elevation by CAS KIT withoutbone graft. Scientific Poster, Osstem Meeting 2013

6. Kyo-Jin Ahn, Young-Kyun Kim. Prospective comparative study of tapered implant with SLA surface at maxillary posterior area accordingto loading time: 3 and 6 months. Scientific Poster, 21st Congress of EAO 2012

7. Yong-Jin Kim, Young-Jin Park, Kyung-Tae Park. Sinus bone grafting with simultaneous implant placement in case of residual bone heightless than 4mm using TSIII SA implant. Scientific Poster, 22nd Congress of EAO 2013

8. Young-Whee Son. Recovery of Alveolar Bone Defect Using Open Membrane Technique with immediate implant placement. ScientificPoster, Osstem Meeting 2013

9. Kwang-Heung Han, Min-Suk Heo. Vertical ridge augmentation with SMARTbuilder in poor bone condition. Scientific Poster, OsstemMeeting 2013

10. Hyung-Sik Do, Young-Il Song, Hwan-Yong Jang, Jin-Yong Lee, Jae-Hyung Lim, Hyun-Seok Jang, Jong-Jin Kwon, Jae-Suk Rim, Eui-SeokLee. A Case of Rehabilitation of Oral Function with Dental Implants Following Panfacial Bone Fracture. Scientific Poster, OsstemMeeting 2013

11. Yong-Jin Kim, Young-Jin Park, Kyung-Tae Park. Case report of Flapless implant surgery with TSIII SA implant; Soft tissue access holeusing a round-ended, high-speed diamond bur. Scientific Poster, Osstem Meeting 2013

12. Jung-Gil Han, Kwan-Soo Park. A case report of TSIII implant-immediate flapless placement of a molar tooth with CAS KIT sinusaugmentation involving membrane perforation perforation. Scientific Poster, Osstem Meeting 2013

13. Young-Il Oh, Kwan-Soo Park. Immediate flapless placement of incisor, premolar and molar - a case of TSIII implant. Scientific Poster,Osstem Meeting 2013

14. Hseuh-Yu Li, Kwan-Soo Park. An experience of immediate flapless placement of TSIII without drilling and initial stability. ScientificPoster, Osstem Meeting 2013

15. Hyun-Ki Cho. Immediate placement and loading of dental implants. Clinical result. Scientific Poster, Osstem Meeting 2013

16. Young-Hak Oh. Immediate Loading of the Edentulous Maxilla: a case series. Scientific Poster, Osstem Meeting 2013

17. Choon-Mo Yang. Immediate implant placement and immediate loading with Osstem TSIII implants and chair-side provisionalrestoration in mandibular anterior partial edentulism. Scientific Poster, 21st Congress of EAO 2012

18. Choon-Mo Yang. Full mouth rehabilitation utilizing the CAD/CAM Technology : Surgical Guide for Flapless surgery, Provisionalrestoration and screw-retained Fixed Complete Denture. Scientific Poster, 21st Congress of EAO 2012

19. Byung-Ho Kim, In-Jae Won. Case of Restoration with Fixed Prosthesis for Maxillary Anterior Implants Using SMARTbuilder andSmartFit. Scientific Poster, Osstem Meeting 2013

20. Jong-Hwan Park. SmartFit Abutment case report. Scientific Poster, Osstem Meeting 2013

21. Hwee-Woong Park. An Implant-Supported Restoration of a Maxillary Central Incisor Using a Temporary Abutment and a CustomizedCAD/CAM Titanium Abutment. Scientific Poster, 21st Congress of EAO 2012

22. Ki-Seong Kim. SmartFit Abutment and Smart Healing Abutment. Scientific Poster, 21st Congress of EAO 2012

23. Choon-Mo Yang. Provisionalization of Implant Restorations with PEEK Temporary Abutments. Scientific Poster, Osstem Meeting 2013

24. Yong-Jin Kim, Young-Jin Park, Kyung-Tae Park. Maxillary anterior bone augmentation using B-Oss (Newly Developed DeproteinizedInorganic Bovine Xenograft). Scientific Poster, 22nd Congress of EAO 2013

25. Ji-Young, Lee. Young-Kyun Kim. Clinical comparative study of immediate loading using tapered implant with hydroxyapatite coating atthe partial edentulous ridge of posterior maxilla and mandible. Scientific Poster, 21st Congress of EAO 2012

1. Jae-Chan Heo, Jae-Ho Ryu, Jung-Hwa Oh, Tae-Hyung Kim, Tae-Gwan Eom. Comparative study on the durability of abutment postaccording to tightening torque and cantilever volume. Scientific Poster, Osstem Meeting 2013

2. Yung-Soo Kim, Young-Jun Lim. Primary Stability and Self-Tapping Blades: Biomechanical Assessment of Dental Implants in Medium-Density Bone. Clin. Oral Impl. Res. 2011(22) 1179-84

3. Duck-Rae Kim, Young-Jun Lim, Myung-Joo Kim, Ho-Beom Kwon, Sung-Hun Kim. Self-Cutting Blades and their Influence on PrimaryStability of Tapered Dental Implants in a Simulated Low-Density Bone Model: a laboratory study. Oral Surg Oral Med Oral Pathol OralRadiol Endod 2011(112);573-80

4. Tae-Gwan Eom, Seung-Woo Suh, Myung-Duk Kim, Young-Kyun Kim, Seok-Gyu Kim. Influence of Implant Length and Insertion Depth onStress Analysis: a Finite Element Study. Scientific Poster, Academy of KSME 2011

5. Tae-Gwan Eom, In-Ho Kim, Insertion Torque Sensitivity of TSIV SA Fixture in Artificial Bone Model. Scientific Poster, Osstem WorldMeeting 2011

1. Yee-Seo Kwon, Hee Namgoong, Jung-Hoon Kim, In-Hee Cho, Myung-Duk Kim, Tae-Gwan Eom, Ki-Tae Koo. Effect of microthreads onremoval torque and bone-to-implant contact: an experimental study in miniature pigs. J Periodontal Implant Sci 2013;43:41-6

2. Hong-Young Choi, Jae-June Park, Su-Kyung Kim, Tae-Gwan Eom. Enhancement of in vitro osteogenesis to chemically activated CAsurface compared with SA surface. Scientific Poster, Osstem Meeting 2013

3. Eul-Rak Song, Kyung-Won Cho, Jae-Kwan Lee, Heung-Sik Um, Beom-Seok Chang, Si-Young Lee. Effect of photodynamic therapy onaggregatibacter actinomycetemcomitans attached on titanium surfaces. Scientific Poster, Osstem Meeting 2013

4. Kyung-Won Ha, Woo-Jung Kim, Kin-Won Hong, Hyun-Man Kim. High Osseointegration Rate of BA Implant. Scientific Poster, OsstemMeeting 2013

5. Hee-Jin Gu, Su-Kyoung Kim, Hong-Young Choi, Myung-Duk Kim, Yong-Seok Cho, Tae-Gwan Eom. Evaluation of biomechanical effect onchemically modified Ca-SA surface in vivo. Scientific Poster, 21st Congress of EAO 2012

6. Hong-Young Choi, Su-Kyung Kim, Jae-Jun Park, Tae-Gwan Eom. Enhancement of in Vitro Osteogenesis on Sandblasted and Acid EtchedSurfaces with Rough Micro-topography. Scientific Poster, Osstem World Meeting 2011

7. Hong-Young Choi, Jae-June Park, Su-Kyung Kim, Tae-Gwan Eom. The Effects of Surface Roughness on the Sandblasted with Large GritAlumina and Acid Etched Surface Treatment: In Vitro Evaluation. Scientific Poster, Osstem World Meeting 2011

8. Hong-Young Choi, Jae-June Park, In-Hee Cho, Tae-Gwan Eom. The Effects of Surface Roughness on the Sandblasted with Large GritAlumina and Acid Etched Surface Treatment: In Vivo Evaluation. Scientific Poster, Osstem World Meeting 2011

9. In-Hee Cho, Hong-Young Choi, Woo-Jung Kim, Tae-Gwan Eom. Biomechanical and Histomorphometrical Evaluation of Bone-ImplantIntegration at Sand Blasting with Alumina and Acid Etching (SA) Surface. Scientific Poster, 19th Congress of EAO 2010

10. Tae-Gwan Eom, Gyeo-Rok Jeon, Chang-Mo Jeong, Young-Kyun Kim, Su-Gwan Kim, In-Hee Cho, Yong-Seok Cho, Ji-Su Oh.Experimental Study of Bone Response to Hydroxyapatite Coating Implants: BIC and Removal Torque Test. Oral Surg Oral Med OralPathol Oral Radiol 2012;114(4):411-8

11. Tae-Gwan Eom, Young-Kyun Kim, Jong-Hwa Kim, In-Hee Cho, Chang-Mo Jeong, Yong-Seok Cho. Experimental Study about the BonyHealing of Hydroxyapatite Coating Implants. J Korean Assoc Oral Maxillofac Surg 2011;37(4):295-300

12. Min-Woo Kim, Tae-Gwan Eom. Surface Property Evaluation According to the High Crystallinity of the TSIII HA Implant. ScientificPoster, Osstem World Meeting 2011

13. June-Cheol Hwang, Hong-Young Choi, Tae-Gwan Eom. Architectural Feature of TSIII HA Implant. Scientific Poster, Osstem WorldMeeting 2011

Clinical Study

TS SYSTEM References

Pre-Clinical StudyBiology

Pre-Clinical StudyBiomechanics

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ObjectiveTo analyze the success and survival rates of the Osstem GSII(Osstem, Seoul, Korea) implant in type IV bone.

Materials & MethodsA prospective, multicenter (5 centers) study was conductedby examining the relationship between implant success andsurvival rates, and several patient and surgical parameters.The implants were placed in 82 patients who visited severalnationwide dental hospitals and clinics between 2007 and2008, followed by clinical and radiographic analyses.

Results In type IV bone, the implant success and survival rates were93.23% and 95.83%, respectively. The maxillary premolar andmandibular anterior tooth areas showed success rates of 100%.The most widely used implant diameter and length was 5.0 and13 mm, respectively, but the diameter and length had no effecton success rates. However, success rates appeared to decreasewith age.

ConclusionsThe results indicated that the Osstem GSII implant is highlyeffective in poor-quality type IV bone.

A Multicenter Prospective Study in Type IV Bone of a Single Type of Implant

Table 1. General Conditions and Smoking Habit

Table 4. Clinical Results According to Site

Diabetes mellitus 13

Cardiovascular disease 13

Hypertension 1

Liver disease 2

Heart disease 2

Smoking habit 17

Table 2. Distribution of Implants by Length and Diameter

Length (mm)

3.5 4 2 6

4.0 9 34 32 1 76

4.5 1 2 2 11 3 19

5.0 8 1 10 31 35 2 87

5.5 1 2 1 4

Total 10 3 21 67 83 8 192

Diameter (mm) 7 8.5 10 11.5 13 15 Total

Table 3. Distribution of Operation Methods

Operation MethodsNo. of

Implants

Sinus lift via osteotome technique 35

Sinus lift via lateral window opening 6

Onlay graft 21

GBR 37

Onlay graft + GBR 5

Split crest + GBR 6

Conventional method 82

Table 5. Distribution of Implants by Bone Resorption

Amount of BoneResorption (mm)

No. ofImplants

None 179

0-0.9 4

1.0-2.0 6

>2.0 0

Osstell Mentor Mean (wk)Success

Rates, n (%)

Upper anterior tooth 62.3±10.4 17.8 14/15(93.33)

Upper premolars 61.4 ±10.8 17.7 41/41 (100)

Upper molars 61.4 ±14.0 17.4 112/115 (97.39)

Lower anterior tooth 59.0±2.8 11.0 2/2 (100)

Lower premolars 62.7±11.5 9.0 2/3 (66.66)

Lower molars 59.0 ±23.7 13.5 13/16(81.25)

ObjectiveThe aim of this study was to compare the survival rate andsurrounding tissue condition of sinus bone grafts withsimultaneous implant placement between 4-month and 6-month occlusal loading after implantation.

Materials & MethodsTwenty-seven patients (61 implants) who were treated withsinus bone grafts (sinus lateral approach) and simultaneousOsstem GSII implant placement from July 2007 to June 2008were included in this study. Of these patients, 14 (31implants) were in the 4-month loading group, and 13 (30implants) were in the 6-month loading group. We investigatedthe implantation type (submerged or nonsubmerged), sinusmembrane perforation, type of prosthesis, opposed toothtype, primary and secondary stability of implants, and crestalbone loss around implant and surrounding tissue conditions.

Results The amounts of crestal bone-loss at the final recall time (12.56±5.95 month after loading) of the 4-month and 6-month loadinggroups were 0.19±0.33 mm and 0.39±0.86 mm, respectively.However, the difference between groups was not statisticallysignificant (P=.211). The width of keratinized mucosa, gingivalindex, plaque index, and pocket depth of the 4-month and 6-month loading groups were 2.50±1.69 mm and 1.73±1.40 mm(P=.081), 0.72±0.83 and 0.59±0.69 (P=.671), 1.11±0.96 and0.76±0.79 (P=.226), 3.56±0.98 mm and 3.65±1.06 mm(P=.758), respectively. The primary stabilities of implants in the 4-month and 6-month loading groups were 61.96±12.84 and56.06±15.55 (P=.120), and the secondary stabilities were 71.85±6.80 and 66.51±11.28 (P=.026), respectively. The secondarystability of the 4-month group was significantly higher than that ofthe 6-month group. There was no statistical difference (P>.05)between the 4-month and 6-month loading groups regarding theimplantation type (submerged or nonsubmerged), sinusmembrane perforation, type of prosthesis, or opposed toothtype. In the 4-month and 6-month groups, all of the implantssurvived until the final recall time.

Conclusions For the cases in which the residual bone was 3 mm andprimary implant stability could be obtained, we conclude thatloading is possible 4 months after the sinus bone graft andsimultaneous implant placement.

Comparison of Clinical Outcomes of Sinus Bone Graft with Simultaneous Implant Placement: 4-Month and 6-Month Final Prosthetic Loading

Table 1. Condition of the adjacent tissue around the implants

Index Occlusal loading4 months 6 months

Crestal bone loss (mm) 0.19 ± 0.33 0.39 ± 0.86

Width of keratinized mucosa (mm) 2.50 ± 1.69 1.73 ± 1.40

Plaque index 1.11 ± 0.96 0.76 ± 0.79

Gingival index 0.72 ± 0.83 0.59 ± 0.69

Probing pocket depth (mm) 3.56 ± 0.98 3.65 ± 1.06

Table 2. Residual bone height (mm)

Occlusal loading4 months 6 months

Before operation 5.38 ± 1.95 4.52 ± 1.71

Immediately after operation 17.26 ± 3.22 16.64 ± 1.87

1 year after operation 15.58 ± 2.03 15.48 ± 2.29

Table 3. Primary and secondary stability (implant stability quotient) ofimplants

Occlusal loading4 months 6 months

Primary 61.96 ± 12.84 56.06 ± 15.55

Secondary 71.85 ± 6.80 66.51 ± 11.28

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ObjectiveThe purpose of this study was to evaluate the stability oftapered resorbable blasting media (RBM) surface implants inthe posterior maxilla.

Materials & MethodsFrom September 2008 through January 2010, 20 patients (9male, 11 female) who were treated with tapered GSIIIimplants at Seoul National University Bundang Hospital wereidentified. Thirty-eight implants (14 premolar and 24 molar)were placed in maxillary posterior areas.

ResultsIn this study, 38 taper-shaped implants were placed in 20patients who were followed up for 1 year. The followingconclusions were obtained.1. Regarding implant stability, the average ISQ value at the time of

placement was 63.6 and was 74.4 at the time of the 2ndsurgery, which was a significant increase. The cumulativesurvival rate of 12 months after prosthesis placement was97.4%, and the success rate was 94.7%.

2. The resorption rate of marginal bones 12 months afterprosthesis was an average of 0.19 mm, and stable resultswere shown. Significant differences according to the diameterand length of implants were not shown.

3. The group that received maxillary sinus bone graft wascompared with the group that did not receive the procedure.The ISQ value and the marginal bone resorption rate were notsignificantly different.

ConclusionsThere was no significant difference in crestal bone lossaccording to implant diameter or length or sinus bone graft.This study showed the favorable clinical outcome of taperedimplants that were placed in the maxillary posterior area.

Prospective Study of Tapered RBM Surface Implant Stability in the Maxillary Posterior Area

Table 1. ISQ (Implant stability quotient) value change

ISQ 63.6 ± 14.1 74.4 ± 7.2 .000

1st op 2nd op p

Table 3. Implant survival rate of GSIII implants

No. 37 1 97.4%

Survival Fail Survival rate

Table 4. CBL 12 month after final prosthesis delivery according to diameterand length

Regular 0.09 ± 0.12

Wide 0.26 ± 0.62

Normal 0.16 ± 0.24

Long 0.22 ± 0.61

CBL p*

P was calculated using paired T-test*Indicates statistically significant difference (p<.05)

Table 2. CBL (crestal bone loss) according to time

CBL (mm) 0.05 ± 0.14 0.09 ± 0.24 0.19 ± 0.47 .011

3 months 6 months 12 months p

P was calculated using repeated measures ANOVA*Indicates statistically significant difference (P<.05)

*, Mann-Whitney U-test was performed; insignificant differences were seen according toimplant diameter and length (p>.05)

Diameter .949

.404Length

Table 5. Comparison between implants with and without sinus grafts

1st op 67.6 ± 7.4 62.5 ± 15.7 .501

2nd op 75.3 ± 6.6 74.0 ± 7.4 .831

3M 0.01 ± 0.03 0.06± 0.16 .452

6M 0.01 ± 0.03 0.11 ± 0.27 .314

12M 0.07 ± 0.13 0.23 ± 0.53 .361

With sinus graft (N=9) Without sinus graft (N=29) p*

*, Mann-Whitney U-test was performed; insignificant differences were seen between the group with sinus graft and the group withoutsinus graft (p>.05)

ISQ

CBL

ObjectiveDespite several reports on the clinical outcomes of flaplessimplant surgery, limited information exists regarding theclinical conditions after flapless implant surgery.The objective of this study was to evaluate the soft tissueconditions and marginal bone changes around dentalimplants 1 year after flapless implant surgery.

Materials & MethodsFor the study, 432 implants were placed in 241 patients byusing a flapless 1-stage procedure. In these patients, peri-implant soft tissue conditions and radiographic marginal bonechanges were evaluated 1 year after surgery.

Results None of the implants were lost during follow-up, giving a successrate of 100%. The mean probing depth was 2.1 mm (SD 0.7),and the average bleeding on probing index was 0.1 (SD 0.3). Theaverage gingival index score was 0.1 (SD 0.3), and the meanmarginal bone loss was 0.3 mm (SD 0.4 mm; range 0.0-1.1 mm).Ten implants exhibited bone loss of >1.0 mm, whereas 125implants experienced no bone loss at all.

ConclusionsThe results of this study demonstrate that flapless implantsurgery is a predictable procedure. In addit ion, it isadvantageous for preserving crestal bone and mucosalhealth surrounding dental implants.

A 1-Year Prospective Clinical Study of Soft Tissue Conditions and Marginal Bone Changes Around Dental Implants After Flapless Implant Surgery

Fig. 1. Clinical features after punching thesoft tissue at the proposed implantsites with a 3-mm soft tissuepunch.

Fig. 2. Clinical features after healingabutments were connected to thefixtures.

Fig. 3. Periapical radiograph taken immediately (A) and 1 year (B) after implant placement.

Fig. 4. Number of implants that exhibited varying amounts of boneloss during the healing period from the time of implantplacement to the 1-year follow-up.

Table 1. Probing depth, gingival index, bleeding on probing index, andcrestal bone loss when implants were placed without a flap

Index 1 year

Probing depth (mm) 2.1 ± 0.7

Bleeding on probing index 0.1 ± 0.3

Gingival index 0.1 ± 0.3

Crestal bone loss 0.3 ± 0.4

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ObjectiveA waiting period of two weeks after osteotomy increases thesurrounding tissue activity to its maximum level as collagenformation and neoangiogenesis represents a relaxed andacceptable implant bed configuration.The aim of the present study was a clinical and radiologicalevaluation of early osteotomy with implant placement delayedfor two weeks with immediate loading in the anterior andpremolar region with minimally invasive approach.

Materials & MethodsA total of seven GSII implants (Osstem) were placed in sixpatients. Osteotomy was done followed by flap closurewithout the placement of implant. After approximately waitingfor a period of two weeks, implant placement was donewhich were loaded immediately with provisional crown inimplant protected occlusion. It was replaced by definitiverestoration after 6-8 weeks which was considered asbaseline. Implant stability and marginal bone levels wereassessed with clinical and radiological parameters atbaseline, 6th and 12th month intervals.

Results None of the implants were found mobile during the one yearperiod. The amount of average mean marginal bone loss was 0.4mm over the one year follow up period.

Conclusions In the present study, early osteotomy with delayed implantplacement showed negligible crestal bone loss with nomobility.

A Relaxed Implant Bed: Implants Placed After Two Weeks of Osteotomy with Immediate Loading: A One Year Clinical Trial

Table 1. Mean values of width of keratinized mucosa index

Assessment Time Mean ± SD % Change frombaseline

Baseline 2.00 ± 0.63 -

6th Month 2.17 ± 0.41 -8.5%

12th Month 2.33 ± 0.52 -16.5%

Table 2. Mean values of peri-implant probing depth


Baseline 2.38 ± 0.54 -

6th Month 2.29 ± 0.33 3.36%

12th Month 2.08 ± 0.34 12.18%

Table 3. Mean values of marginal bone levels on mesial aspect


Baseline 0.36 ± 0.54 -

6th Month 0.37 ± 0.36 13.88%

12th Month 0.36 ± 0.41 -13.88%

Table 4. Mean values of marginal bone levels on distal aspect


Baseline 0.54 ± 0.50 -

6th Month 0.50 ± 0.41 5.55%

12th Month 0.53 ± 0.42 1.85%

ObjectiveThe objective of this study was to evaluate the sinus bonegraft resorption and marginal bone loss around the implantswhen allograft and xenograft are used.

Materials & MethodsSinus bone grafting and implant placement (Osstem, Korea)were performed on 28 patients from September 2003 toJanuary 2006. In group I, a total of 49 implants were placedin 23 maxillary sinus areas of 16 patients together with bonegraft using xenograft (Bio-Oss�) and a minimal amount ofautogenous bone. In group II, 24 implants were placed in 13maxillary sinus areas of 12 patients together with bone graftusing a minimal amount of autogenous bone and equalamounts of allograft (Regenaform�) and Bio-Oss� in group II.

Results Early osseointegration failures of 3 implants in 3 patients(group I: 1 patient, 1 implant; group II: 2 patients, 2 implants)were observed, and revisions were performed for these 3implant sites, fol lowed by complete prosthodontictreatments. The average height of the remaining alveolarbone before the surgery, immediately after the surgery, and 1year after the surgery was 4.9 mm, 19.0 mm, and 17.2 mm,respectively, in group I. In group II, the average height of theremaining alveolar bone was 4.0 mm, 19.2 mm, and 17.8mm before the surgery, immediately after the surgery, and 1year after the surgery, respectively. The average marginalbone loss 1 year after prosthodontic loading and after 20.8months’ follow-up was 0.6 mm and 0.7 mm, respectively, ingroup I. A 93.9% success rate was observed for group I, with3 implants showing bone resorption of >1.5 mm within 1 yearof loading. For group II, the average marginal bone loss 1year after prosthodontic loading and after 19.7 months’follow-up was 0.7 mm and 1.0 mm, respectively. An 83.3%success rate was observed for group II, with 4 implantsshowing bone resorption of >1.5 mm within 1 year of loading.

ConclusionsBased on the observations in this study, it was concludedthat mixed grafting with demineralized bone matrix formaxillary sinus bone grafting has no significant short-termmerit regarding bone healing and stability of implantscompared with anorganic bovine bone alone.

Evaluation of Sinus Bone Resorption and Marginal Bone Loss After Sinus Bone Grafting and Implant Placement

Table 1. Marginal bone loss (mm) around the implants

No. of implants 1 yr loading Final F/U

Group I 49 0.63 ± 0.51* 0.73 ± 0.52�

Group II 24 0.68 ± 0.86* 0.98 ± 1.58�

F/U, Follow-up.* P = .725.�P = .315 (between groups).

Table 2. Comparison in terms of marginal bone loss (mm) 1 year and finalfollow up after the completion of the upper prosthesis

No. of implants 1 yr loading Final F/U

0.62 ± 0.54�0.80 ± 0.51�

0.58 ± 0.57*0.65 ± 0.48*

1930

0.43 ± 0.46§1.37 ± 1.96§

0.38 ± 0.48�0.90 ± 1.02�

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Group IDelayed placementSimultaneous placement

Group IIDelayed placementSimultaneous placement

F/U, Follow-up.

* P .649.

�P .148.

�P .255.

§P .153 (between delayed and simultaneous placement in each group).

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ObjectiveThe purpose of this study was to evaluate the responses ofperi-implant tissue in the presence of keratinized mucosa.

Materials & MethodsA total of 276 implants were placed in 100 patients. From thetime of implant placement, the average follow-up observationperiod was 13 months. The width of keratinized mucosa wascompared and evaluated through the gingival inflammationindex (GI), plaque index (PI), the pocket depth, mucosalrecession, and marginal bone resorption.

Results The GI, PI, and pocket depth in the presence or absence ofthe keratinized gingiva did not show statistically significantdifferences. However, mucosal recession and marginal boneresorption experienced statistically significant increases in thegroup of deficient keratinized mucosa. Based on implantsurface treatments, the width of keratinized gingiva andcrestal bone loss did not show a significant difference.

ConclusionsIn cases with insufficient keratinized gingiva in the vicinity ofimplants, the insufficiency does not necessarily mediateadverse effects on the hygiene management and soft tissuehealth condition. Nonetheless, the risk of the increase ofgingival recession and the crestal bone loss is present.Therefore, it is thought that from the aspect of long-termmaintenance and management, as well as for the arearequiring esthetics, the presence of an appropriate amount ofkeratinized gingiva is required.

Evaluation of Peri-implant Tissue Response According to the Presence of Keratinized Mucosa

Table 1. Width of keratinized mucosa according to implant systems

RBM SLA Anodizing Sig.

Width of DKM (mm) 0.64 ± 0.49 0.40 ± 0.50 0.56 ± 0.51 .157

Width of SKM (mm) 3.26 ± 1.40 3.04 ± 1.29 3.19 ± 1.18 .614

DKM, Insufficient keratinized mucosa, width 2 mmSKM, sufficient keratinized mucosa, width 2 mmRBM, Resorbable blasting media (Osstem USII / GSII)SLA, sandblasted with large grit and acid-etched (Dentium Implantium)Anodizing, Nobel Biocare TiUniteother abbreviations as in

Table 2. Crestal bone loss according to implant system

Sig.Bone loss (mm)Impalant system

Implantium 0.54 ± 0.83 .36

TiUnite 0.44 ± 0.72

GSII 0.39 ± 0.71

USII 0.60 ± 0.84

P > .05

ObjectiveAlthough it has been shown that the exclusion of themucoperiosteal f lap can prevent postoperative boneresorption associated with flap elevation, there have beenonly a few studies on the peri-implant mucosa followingflapless implant surgery. The purpose of this study was tocompare the morphogenesis of the peri-implant mucosabetween flap and flapless implant surgeries by using a caninemandible model.

Materials & MethodsIn six mongrel dogs, bilateral edentulated flat alveolar ridgeswere created in the mandible. After 3 months of healing, 2implants were placed in each side by either the flap or theflapless procedure. Three months after implant insertion, theperi-implant mucosa was evaluated by using clinical,radiologic, and histometric parameters, which included thegingival index, bleeding on probing, probing pocket depth,marginal bone loss, and the vertical dimension of the peri-implant tissues.

Results The height of the mucosa, length of the junctional epithelium,gingival index, bleeding on probing, probing depth, andmarginal bone loss were all significantly greater in the dogsthat had the flap procedure than in those that had theflapless procedure (p < .05).

Conclusions These results indicate that gingival inflammation, the height ofjunctional epithelium, and bone loss around nonsubmergedimplants can be reduced when implants are placed withoutflap elevation.

Morphogenesis of the Peri-Implant Mucosa: A Comparison Between Flap and Flapless Procedures in the Canine Mandible

Table 1. Parameters of probing depth, gingival index and bleeding onprobing around implants when placed with or without a flap

Flapless group P valueFlap group

Probing depth (mm) 1.7 ± 0.3 1.0 ± 0.3 .006

Gingival index 0.9 ± 0.5 0 .005

Bleeding on probing 0.7 ± 0.4 0 .005

Table 2. Results of the histometric measurements in both the flap andflapless groups

PM, marginal position of the peri-implant mucosa; B, marginal level of bone-to-implantcontact; aJE, apical termination of the junctional epithelium.

Flapless group P valueFlap group

PM-B (mm) 3.5 ± 0.8 2.2 ± 0.2 .007

PM-aJE (mm) 2.2 ± 0.3 1.2 ± 0.3 .003

aJE-B (mm) 1.3 ± 0.2 1.0 ± 0.2 .018

Fig. 1. Magnified view of the specimens showing the peri-implant mucosa.(X 12 magnification). A, Implant placed with a flap. B, Implant placed without a flap.

A B

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ObjectiveSeveral studies have reported on spontaneous earlyexposure of submerged implants, suggesting that exposedimplants have greater bone loss than nonexposed implants.The purpose of this study was to compare the effects ofimplant-abutment connections and partial implant exposureon crestal bone loss around submerged implants.

Materials & MethodsBilateral, edentulated, flat alveolar ridges were created in themandible of 6 mongrel dogs. After 3 months of healing, 2fixtures were placed on each side of the mandible following acommonly accepted 2-stage surgical protocol. The fixtureson each side were randomly assigned to 1 of 2 procedures.In the first, a cover screw was connected to the fixture, andthe incised gingiva was partially removed to expose the coverscrew (partially exposed group). In the second, a healingabutment was connected to the fixture so that the coronalportion of the abutment remained exposed to the oral cavity(abutment-connected group). After 8 weeks, micro-computed tomography (micro-CT) at the implantation sitewas performed to measure the bone height in the peri-implant bone. Data were analyzed by Wilcoxon’s signed ranktest.

Results The average bone height was greater for the abutment-connected fixture (9.8 ± 0.5 mm) than for the partiallyexposed fixture (9.3 ± 0.5 mm; p < .05).

ConclusionsThese results suggest that when implant exposure isdetected, the placement of healing abutments may help limitbone loss around the submerged implants.

Influence of Premature Exposure of Implants on Early Crestal Bone Loss: An Experimental Study in Dogs

ObjectiveThe purpose of this study was to evaluate the levels ofmicroleakage through the access holes of screw-retainedimplant prostheses sealed with different materials.

Materials & MethodsAn implant with an internal hexagonal configuration wasconnected to a temporary abutment with an acrylic resincrown. The apical 6.5 mm of the access hole was filled with 1of the following materials: cotton pellet, silicone sealingmaterial, vinyl polysiloxane, or gutta-percha. The remainingcoronal 3 mm was sealed with composite resin. Cyclicloading with 21 N at 1 Hz was applied 16 000 times to thespecimens in 0.5% basic fuchsin solution according to thelong axis of the tooth. Basic fuchsin dye which penetratedinto the internal wall of the abutment through the access holewas dissolved with methyl alcohol. Then the absorbance wasmeasured by a spectrophotometer at 540 nm to evaluate thedegree of microleakage. The results were statisticallyanalyzed with 1-way ANOVA and the Tukey HSD test.

Results From greatest to least, the levels of microleakage were in thefollowing order: cotton pellet, silicone sealing material, vinylpolysiloxane, and gutta-percha. The microleakage associatedwith gutta-percha was not significantly different from that ofvinyl polysiloxane.

ConclusionsWhen sealing the access holes of screw-retained implantprostheses, gutta-percha or vinyl polysiloxane would helpreduce microleakage.

Microleakage of Different Sealing Materials in Acess Holes of Internal Connection Implant Systems

Fig. 1. Clinical features after implant placement. In implant A, a cover screw was connected to the fixture and the incised gingiva waspartially removed to expose the implant. In implant B, a healing abutment was connected to the fixture so that the coronal portion ofthe abutment remained exposed to the oral cavity.

Fig. 1. A, Structure of temporary implant prosthesis,B, Structure of screw-retained implant restoration connected to implant with

sealed access hole.

Fig. 3. Process to measure microleakage after cyclic loading

Fig. 4. A, Cotton pellet removed from access hole and temporary abutment in controlgroup.

B, Magnified image of cervical neck of temporary abutment.

Fig. 5. Average absorbance according to access hole sealing materials.

Fig. 2. A, Specimen placed in device of cyclic loading machine. B, Schematic drawing of specimen dipped in dye under loading. C, Location of load on occlusal surface specimen. D, Cyclic loading machine.

Fig. 2. Three-dimensional micro-CT showing the bone (yellow) around implants (gray). A, Partially exposed implant. B, Abutment-connected implant. Buccal, buccal side of the alveolus; lingual,

lingual side of the alveolus.

LingualBuccalA LingualBuccalB

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Table. 1. Implant systems used in this study

Abutment ScrewFixtureGroup

EXTNTS USII (US2R413) TiN Coated (CAR535C) ASR200

EXANTS USIII (US3R413) Safe (SFAR542C) SFSR2S

EXZRTS Bio Tapered Double Thread (BDT413) ZioCera (ZAR535) ASR200

INTIWS GSII (GS2R4013) GS Transfer (GSTA5430S) GSASR

INTICS SSI (SS1R1813) Solid (SSS485) -

ObjectiveThis study evaluated the fatigue limit of five implant-abutmentcombinations (Osstem Implant, Korea). The fatigue testswere performed to evaluate the impact of fatigue on theeffectiveness of dental implant-abutment assembiies withdifferent joint designs and with different abutment materials,with a special emphasis on the pattern of the dental implantfixture and the abutment, as well as the effect of theabutment material on the stability of the joint area.

Materials & MethodsEach implant-abutment system (EXTNTS: USII-TiN Coated,EXANTS: USIII-Safe, EXZRTS: BioTapered Double Thread-ZirAce, INTIWS: GSII-GS Transfer, INTICS: SS I-Solid) wastightened with a closing torque of 32 Ncm. The testspecimen was loaded at an incline of 30 degrees toward theloading direction after fixing it 11 mm away from the fixedpoint. A cyclic compression load was applied at loadingcycles of 10 Hz using a hydraulic dynamic testing machine(Model 8516, Instron, USA).

Results & Conclusions The mean static strength of the EXZRTS group was largest at1772.2 N and that of the INTIWS group was smallest at893.8 N. Turkey analysis showed that the group with theabutment joint with the external hexagonal structure patternhad a significantly higher mean static strength than the groupwith the internal hexagonal structure pattern (p < .05). Thefatigue limit that guarantees a 5×106 cycle life according tothe condition established by the ISO/FDIS 14801:2003(E) inall experiment groups was shown to be 300~800 N. Thefatigue limit that was compared with the static strength wasfound to be relatively high in the cases with a tapered shapethan an external hexagonal shape. In the cases where theshape of the screw joint was an external hexagonal structure,the fatigue limit was relatively higher in cases using thezirconia abutment than the titanium abutment. The fatiguefracture of the zirconia abutment was initiated in the marginwith a subsequent sudden unstable fracture.

Fatigue Characteristics of Five Types of Implant-Abutment Joint Designs

Fig. 3. Fatigue load vs cycles to failure of each experimental group : (a)EXTNTS,(b)EXANTS, (c) EXZRTS, (d) INTIWS, (e) INTICS.

Fig. 1. Static fracture strength of eachexperimental group.

Fig. 2. Load vs displacementcurve of EXZRTS group.

ObjectivePrimary stability at the time of implant placement is related tothe level of primary bone contact. The level of bone contactwith implant is affected by thread design, surgical procedureand bone quality, etc.The aim of this study was to compare the initial stability of thevarious taper implants according to the thread designs, halfof which were engaged to inferior cortical wall of type IV bone(Group 1) and the rest of which were not engaged to inferiorcortical wall (Group 2) by measuring the implant stabilityquotient (ISQ) and the removal torque value (RTV).

Material & MethodsIn this study, 6 different implant fixtures with 10 mm lengthwere installed. In order to simulate the sinus inferior wall oftype IV bone, one side cortical bone of swine rib wasremoved. 6 different implants were installed in the same boneblock following manufacturer's recommended procedures.Total 10 bone blocks were made for each group. The heightof Group 1 bone block was 10 mm for engagement and thatof group 2 was 13 mm. The initial stability was measured withISQ value using Osstell mentorTM and with removal torqueusing MGT50 torque gauge.

Results In this study, we found the following results. 1. In Group 1 withfixtures engaged to the inferior cortical wall, there was nosignificant difference in RTV and ISQ value among the 6 types ofimplants. 2. In Group 2 with fixtures not engaged to the inferiorcortical wall, there was significant difference in RTV and ISQ valueamong the 6 types of implants (p < .05). There was significant difference in RTV and ISQ valueaccording to whether fixtures were engaged to the inferiorcortical wall or not (p< .05). 4. Under-drilling made RTV andISQ value increase significantly in the NT implants which hadlower RTV and ISQ value in Group 2 (p < .05).

ConclusionsWithout being engaged to the inferior cortical wall fixtures hadinitial stability affected by implant types. Also in poor quality bone,under-drilling improved initial stability.

The Effect of Various Thread Designs on the Initial Stability of Taper Implants

Fig. 2. A. 6 implants ware installed with engageing (Group 1).B. 6 implants were installed without engaging (Group 2).

Fig. 1. Characteristics of thread design used in this study.A. GSIII (Osstem, Seoul, Korea), B. Osseotite NT� (3i, Floria, USA), C. Replace� Select (Noble Biocare, Goteborg, Sweden), D. Sinus Quick (Neoplant, Seoul, Korea), E. USIII (Osstem, Seoul, Korea), F. Hexplant (Warantec, Seoul, Korea.)

A A BB C D E F

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1. Sok-Min Ko, Seong-Jae Park, In-Kyung Lee, A Comparison of the Implant Stability Among the Bone Density Groups: Prospective Study.J Dent Rehab App Sci. 2013;29(1):11-21

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3. Jingxu Li, Feng Xuan, Byung-Ho Choi, Seung-Mi Jeong. Minimally invasive ridge augmentation using xenogenous bone blocks in anatrophied posterior mandible: a clinical and histological study. Implant Dent. 2013 Apr;22(2):112-6

4. Mi-Ae Jeong, Su-Gwan Kim, Young-Kyun Kim, Hee-Kyun Oh, Yong- Seok Cho, Woo-Cheol Kim, Ji-Su Oh. A Multicenter ProspectiveStudy in Type IV Bone of a Single Type of Implant. Implant Dent. 2012 Aug;21(4):330-4

5. Kwang Chung, Chul-Jung Oh, Ji-Won Ha, Min-Suk Kook, Hong-Ju Park, Hee-Kyun Oh, Su-Gwan Kim, Young-Kyun Kim, Woo-Cheol Kim. Amulticenter clinical study of installed USII Plus/GSII Osstem implants after bone graft. Korean Dental Association. 2012;50(12:743-54

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8. Yong-Seok Cho, Kyung-Gyun Hwang, Chang-Joo Park. Postoperative effects of anterior nasal spine bone harvesting on overall nasalshape. Clin Oral Implants Res. 2013 Jun;24(6):618-22

9. Seung-Hwan Jeon, Yong-Seok Cho, Byung-Ha Lee, Tae-Yun Im, Kyung-Gyun Hwang, Chang-Joo Park. Evaluation of the feasibility ofbony window repositioning without using a barrier membrane in sinus lateral approach. J Korean Assoc Oral Maxillofac Surg2011;37:122-6

10. Hee-Jung Yun, Jung-Chul Park, Jeong-Ho Yun, Ui-Won Jung, Chang-Sung Kim, Seong-Ho Choi, Kyoo-Sung Cho. A short-term clinicalstudy of marginal bone level change around microthreaded and platform-switched implants. J Periodontal Implant Sci 2011;41:211-7

11. Jong-Won Jung, Su-Gwan Kim, Seong-Yong Moon, Ji-Su Oh. A Prospective Multicenter Study on the Clinical Success Rate of theOsstem Implant (New GSII RBM) in Edentulous Patients. Implantology 2011; 15(2):142-52

12. Min-Jung Kwon, Young-Kyun Kim, In-Sung Yeo, Yang-Jin Yi. Clinical Comparison of Immediately Loaded and Delayed Loaded OsstemGSIII Implant in Partially Edentulous Patients. J Dent Rehab App Sci. 2011;27(3):267-75

13. Sang-Woon Moon, Young-Kyun Kim. Analysis of Prognostic Factors after a Variety of Osstem Implant Installation. Implantology2011;15(2):170-9

14. Young-Kyun Kim, Su-Gwan Kim, Jin-Young Park, Yang-Jin Yi, Ji-Hyun Bae. Comparison of Clinical Outcomes of Sinus Bone Graft withSimultaneous Implant Placement: 4-month and 6-month Final Prosthetic Loading. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2011 Feb;111(2):164-9

15. Young-Kyun Kim, Su-Gwan Kim, Jong-Hwa Kim, Yang-Jin Yi, Pil-Young Yun. Prospective study of tapered resorbable blasting mediasurface implant stability in the maxillary posterior area. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Jul;114(1):e19-24

16. Seung-Mi Jeong, Byung-Ho Choi, Ji-Hun Kim, Feng Xuan, Du-Hyeong Lee, Dong-Yub Mo, Chun-Ui Lee. A 1-year Prospective ClinicalStudy of Soft Tissue Conditions and Marginal Bone Changes around Dental Implants after Flapless Implant Surgery. Oral Surg OralMed Oral Pathol Oral Radiol Endod. 2011 Jan;111(1):41-6

17. Soo-Yeon Kim, Young-Kyun Kim. Short-Term Retrospective Clinical Study of Resorbable Blasting Media Surface Tapered Implants. JKorean Assoc Maxillofac Plast Reconstr Surg 2011;33(2):149-53

18. Young-Kyun Kim. Early loading after sinus bone graft and simultaneous implant placement. Australasian Dental Practice2011(March/April): 136-42

19. Bansal J, Kedige S, Bansal A, Anand S. A Relaxed Implant Bed: Implants Placed After Two Weeks of Osteotomy with ImmediateLoading - A One Year Clinical Trial. J Oral Implantol. 2012 Apr;38(2):155-64

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32. Ka-Young Seol, Su-Gwan Kim, Hak-Kyun Kim, Seong-Yong Moon. A Prospective Study of the Multicenter Clinical Study of OsstemImplant (GSII RBM) in Type IV Bone Quality Patients. Scientific Poster, J Kor Oral Maxillofac Surg 2009;35(Suppl)

33. Jin-Sung Park, Su-Gwan Kim, Hak-Kyun Kim, Seong-Yong Moon. A Prospective Study of the Multi-facilities Clinical Success Rate ofOsstem Implant (GSII RBM) in Edentulous Patient. Scientific Poster, J Kor Oral Maxillofac Surg 2009;35(Suppl)

34. Seo-Yoon Kim, Su-Gwan Kim, Hak-Kyun Kim, Seong-Yong Moon. A Prospective Study of the Multi-facilities Clinical Success Rate ofOsstem Implant (GSII RBM) in Upper Anterior Teeth after Immediate Extraction. Scientific Poster, J Kor Oral Maxillofac Surg2009;35(Suppl)

35. Du-Hyeong Lee, Seung-Mi Jeong, Byung-Ho Choi. Effects of Flapless Implant Surgery on Soft Tissue Profiles: A Prospective ClinicalStudy. Scientific Oral, The 50th Anniversary of KAP, International Prosthodontic Congress & The 6th Biennial Meeting of AsianAcademy of Prosthodontics (AAP) 2009

36. Seong-Yeon Lee, Young-Kyun Kim, Pil-Young Yun, Yang-jin Yi, In-Sung Yeo, Hyo-Jung Lee, Ji-Young Lee. Prospective Clinical Study ofShort Implant. Scientific Poster, 4th Congress of the ICOI Korea 2009

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39. Young-Kyun Kim, Pil-Young Yun, Jae-Hyung Im. Clinical Retrospective Study of Sinus Bone Graft and Implant Placement. J KoreanAssoc Maxillofac Plast Reconstr Surg 2008;30(3):294-302

40. Young-Kyun Kim, Pil-Young Yun, Min-Jung Kwon. Short term Retrospective Clinical Study on GSII, SSIII, USIII. J KoreanImplantology(KAOMI) 2008;12(2):12-22

41. Hye-Rin Joeng, Bo-Ram Byun, Sok-Min Ko, Seung-Il Song. Rehabilitation of Occlusion Using Orthognathic Surgery and ImplantPlacement in Partially Edentulous Patient with Mandibular Prognathism: Case Report. J Korean Implantology(KAOMI) 2008;12(4):48-56

42. Bum-Soo Kim, Young-Kyun Kim, Pil-Young Yun, Yang-Jin Lee. Clinical Evaluation of Sinus Bone Graft Using Allograft and Xenograft.Scientific Poster, 17th Congress of EAO 2008

43. Seo-Yoon Kim, Su-Gwan Kim, Hak-Kyun Kim. A Comparision between the Survival Rate of RBM surface implants and Acid-etchedsurface implants : A prospective 1-year Clinical Study. Scientific Poster, J Kor Oral Maxillofac Surg 2008; 34 (Suppl)

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46. Young-Kyun Kim, Pil-Young Yun, Dae-Il Son, Bum-Soo Kim, Jung-Won Hwang. Analysis of Clinical Application of Osstem (Korea)Implant System for 6 Years. J Korean Implantology(KAOMI) 2006;10(1):56-65

47. Sun-Hee Oh, Taek-Ga Kwon, Young-Kyun Kim, Jung-Won Hwang. Retrospective Study of Osstem Dental Implants; Clinical andRadiographic Results of 2.5 Years. Scientific Poster, 15th Congress of EAO 2006

48. Kyung-Hwan Kwon, Jung-Goo Choi, Seung-Ki Min, Seung-Hwan Oh, Moon-Ki Choi, Jun Lee. GSII Fixture Implant Placement; Reviewof the Factors Affecting Failure.Scientific Poster, 45th Congress of the Korean Assoc Maxillofac Plast Reconstr Surg 2006

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GS SYSTEM References

5. Jae-Myoung Cho, Uk Cho, Mi-Jung Yun, Chang-Mo Jeong, Young-Chan Jeon. Influence of Implant Diameter and Length Changes onInitial Stability. J Kor Acad Prosthodont 2009;47:335-41

6. Duck-Rae Kim, Myung-Joo Kim, Ho-Beom Kwon, Seok-Hyung Lee, Young-Jun Lim. In Vitro Study on the Initial Stability of Two TaperedDental Implant Systems in Poor Bone Quality. J Korean Acad Stomatog Func Occ. 2009;25(4):389-99

7. Sung-Ae Shin, Chang-Seop Kim, Wook Cho, Chang-Mo Jeong, Young-Chan Jeon, Ji-Hoon Yoon. Mechanical Strength of ZirconiaAbutment in Implant Restoration. J Korean Acad Stomatog Func Occ. 2009;25(4):347-58

8. Ju-Hee Park, Yiung-Jun Lim, Myung-Joo Kim, Ho-Beom Kwon. The Effect of Various Thread Designs on the Initial Stability of TaperImplants. J Adv. Prosthodont 2009;1:19-25

9. Mi-Soon Lee, Kyu-Won Suh, Jae-Jun Ryu. Screw Joint Stability under Cyclic Loading of Zirconia Implant Abutments. J Kor AcadProsthodont 2009;47(2):164-73

10. Il-Song Park, Sang-Yong Won, Tae-Sung Bae, Kwang-Yeob Song, Charn-Woon Park, Tae-Gwan Eom, Chang-Mo Jeong. FatigueCharacteristics of Five Types of Implant-Abutment Joint Designs. Met. Mater. Int. 2008;14(2):133-8

11. Hyon-Mo Shin, Chang-Mo Jeong, Yonung-Chan Jeon, Mi-Jeong Yeun, Ji-Hoon Yoon. Influence of Tightening Torque on Implant-Abutment Screw Joint Stability. J Kor Acad Prosthodont 2008;46(4):396-408

12. Chun-Yeo Ha, Chang-Whe Kim, Young-Jun Lim, Myung-Joo Kim. Effect of Casting Procedure on Screw Loosening of UCLA Abutmentin Two Implant-Abutment Connection Systems. J Kor Acad Prosthodont 2008;46(3):246-54

13. Jae-Kyoung Park, Chang-Mo Jeong, Young-Chan Jeon, Ji-Hoon Yoon. Influence of Tungsten Carbide/Carbon Coating of Implant-Abutment Screw on Screw Loosening. J Kor Acad Prosthodont 2008;46(2):137-47

14. Tae-Sik Lee, Jung-Suk Han, Jae-Ho Yang, Jae-Bong Lee, Sung-Hun Kim. The Assessment of Abutment Screw Stability Between theExternal and Internal Hexagonal Joint under Cyclic Loading. J Kor Acad Prosthodont 2008;46(6):561-8

15. Jae-Myoung Cho, Chang-Mo Jeong, Yonung-Chan Jeon, Mi-Jeong Yeun. The Influence of Diameter and Length on Initial Stability inImplant with Similar Surface Area : An Experimental Study. Scientific Poster, J Kor Acad Prosthodont 2008 Conference

16. Chun-Yeo Ha, Chang-Whe Kim, Young-Jun Lim, Myung-Joo Kim, Ho-Bum Kwon. The Influence of Abutment Angulation on ScrewLoosening of Implant in the Anterior Maxilla. Scientific Poster, J Kor Acad Prosthodont 2008 Conference

17. Si-Yeob Kim, Byung-kook Kim, Jin-Ho Heo, Ju-Youn Lee, Chang-Mo Jeong, Yong-Deok Kim. Evaluation of Stability of Double ThreadedImplant-Emphasis on Initial Stability Using Osstell MentorTM; Part I. J Kor Acad Stomatog Func Occlusion 2007;23(4)

18. Seung-woo Suh, Myung-Duk Kim, Tae-Gwan Eom. The Effect of Various Taper Angles of the Internal Morse Taper Connection TypeDental Implant Fixture on Their Stress Distribution by FEA Study. Scientific Poster, 16th Congress of EAO 2007

19. Han-Su Kim, Hee-Jung Kim, Chae-Heon Chung. Detorque Force of TiN-Coated Abutment Screw with Various Coating Thickness afterRepeated Closing and Opening. J Kor Acad Prosthodont 2007;45(6):769-79

20. Chae-Heon Chung. Detorque Force of TiN-coating Abutment Screw with Various Coating Thickness After Repeated Closing andOpening. Scientific Oral, 12th International College of Prosthodontists Meeting, 2007

21. Gap-Yong Oh, Sung-Hwa Park, Seok-Gyu Kim. Influence of Implant Fixture Design on Implant Primary Stability. J Kor Acad Prosthodont2006;45(1):98-106

22. Jin-Uk Choi, Chang-Mo Jeong, Young-Chan Jeon, Jang-Seop Lim, Hee-Chan Jeong, Tae-Gwan Eom. Influence of TungstenCarbide/Carbon on the Preload of Implant Abutment Screws. J Kor Acad Prosthodont 2006;44(2):229-42

23. Mun-Ji Hyun, Cheol-Won Lee, Mok-Kyun Choie. The Effect of Implant Abutment Length, Surface and Cement Type on the ProsthesisRetention. Scientific Poster, 15th Congress of EAO 2006

24. Yong-Suk Cho, Chul-Hyun Jeong , Tae-Soo Kim, Dong-Hoon Jang, Tae-Gwan Eom. Temperature Measurement During Implant-SitePreparation. Scientific Poster, 15th Congress of EAO 2006

25. Ji-Hoon Yoon, Sung-Geun Lee, Chang-Mo Jeong, Tae-Gwan Eom. The Study of Dynamic Behaviour about Implant System with WC/CCoating. Scientific Poster, 15th Congress of EAO 2006

26. Ji-Hoon Yoon, Kim KH, Eom SH, Chang-Mo Jeong, Tae-Gwan Eom, Gyeo-Rok Jeon. A Comparative Anlysis of the Accuracy of ImplantTechniques. Scientific Poster, 15th Congress of EAO 2006

27. Kwang-Hoon Kim, Chang-Mo Jeong, Ji-Hoon Yoon, Ji-Yun Seong. Effect of Implant-Abutment Joint Design on Dynamic FatigueStrength. Scientific Poster, 20th Congress of AO 2005

28. Kwang-Hoon Kim, Chang-Mo Jeong, Ji-Hoon Yoon. The Effect of WC(Tungsten-Carbide) Coating for Abutment Screw on Reliability ofConnection. Scientific Poster, 14th Congress of EAO 2005

29. Tae-Gwan Eom, Chang-Mo Jeong, Kwang-Hoon Kim. The Effect of Tightening Torque on Reliability of Joint Stability. Scientific Poster,14th Congress of EAO 2005

1. Sung-Do Park, Yoon Lee, Yu-Lee Kim, Sang-Hui Yu, Ji-Myung Bae, Hye-Won Cho. Microleakage of different sealing materials in acessholes of internal connection implant systems, J Prosthet Dent 2012(108);173-80

2. Ki-Seong Kim, Young-Jun Lim, Myung-Joo Kim, Ho-Beom Kwon, Jae-Ho Yang, Jai-Bong Lee, Soon-Ho Yim. Variation in the TotalLengths of Abutment/Implant Assemblies Generated with a Function of Applied Tightening Torque in External and Internal Implant-Abutment Connection. Clin. Oral Impl. Res. 2011;22:834-9

3. Tae-Gwan Eom, Seung-Woo Suh, Myung-Duk Kim, Young-Kyun Kim, Seok-Gyu Kim. Influence of Implant Length and Insertion Depth onStress Analysis: a Finite Element Study. Scientific Poster, Academy of KSME 2011

4. Si-Hoon Jo, Kyoung-Il Kim, Jae-Min Seo, Kwang-Yeob Song, Ju-Mi Park, Seung-Geun Ahn. Effect of Impression Coping and ImplantAngulation on the Accuracy of Implant Impressions: An in Vitro Study. J Adv Prosthodont. 2010;2(4):128-33



1. Yee-Seo Kwon, Hee Namgoong, Jung-Hoon Kim, In-Hee Cho, Myung-Duk Kim, Tae-Gwan Eom, Ki-Tae Koo. Effect of microthreads onremoval torque and bone-to-implant contact: an experimental study in miniature pigs. J Periodontal Implant Sci 2013;43:41-6

2. Du-Hyeong Lee, Byung-Ho Choi, Seung-Mi Jeong, Feng Xuan, Ha-Rang Kim, Dong-Yub Mo. Effects of Soft Tissue Punch Size on theHealing of Peri-implant Tissue in Flapless Implant Surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:525-30

3. Ha-Rang Kim, Byung-Ho Choi, Feng Xuan, Seung-Mi Jeong. The Use of Autologous Venous Blood for Maxillary Sinus FloorAugmentation in Conjunction with Sinus Membrane Elevation: An Experimental Study. Clin. Oral Impl. Res. 2010;21:346-9

4. Tae-Min You, Byung-Ho Choi, Jingxu Li, Feng Xuan, Seung-Mi Jeong, Sun-Ok Jang. Morphogenesis of the Peri-implant Mucosa: AComparison between Flap and Flapless Procedures in the Canine Mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2009;107:66-70

5. Jung-In Kim, Byung-Ho Choi, Jingxu Li, Feng Xuan, Seung-Mi Jeong. Blood Vessels of the Peri-implant Mucosa: A Comparison betweenFlap and Flapless Procedures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:508-12

6. Seung-Mi Jeong, Byung-Ho Choi, Jingxu Li, Feng Xuan. Simultaneous Flapless Implant Placement and Peri-implant Defect Correction:An Experimental Pilot Study in Dogs. J Periodontol 2008;79:876-80

7. Je-Hyeon Yoo, Byung-Ho Choi, Jingxu Li, Han-Sung Kim, Chang-Yong Ko, Feng Xuan, Seung-Mi Jeong. Influence of PrematureExposure of Implants on Early Crestal Bone Loss: An Experimental Study in Dogs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2008;105:702-6

8. Seung-Mi Jeong, Byung-Ho Choi, Jingxu Li, Feng Xuan. The Effect of Thick Mucosa on Peri-implant Tissues: An Experimental Study inDogs. J Periodontol 2008;79(11):2151-5

9. Chul-Min Park, Su-Gwan Kim, Hak-Kyun Kim, Seong-Yong Moon, Ji-Su Oh, Sung-Mun Baik, Sung-Chul Lim. Effect on the Osteogenesisof Dental Implants after Horizontal Distraction Osteogenesis with Nitrified Distractor. J Korean Assoc Maxillofac Plast Reconstr Surg2008;30(3):225-31

10. Sung-Lim Choi, Jin-Hwan Kim, Dong-Hyeon Hwang, Seung-Ki Min. Effects on Er,Cr:YSGG Laser on Peri-implantitis. J Korean AssocMaxillofac Plast Reconstr Surg 2008;30(5):428-36

11. Jung-Goo Choi, Su-Jin Choi, Seung-Ki Min, Seung-Hwan Oh, Kyung-Hwan Kwon, Min-Ki Choi, June Lee, Se-Ri Oh. Er:YAG LaserIrradiated Implant Surface Observation with Scanning Electron Microscopy. J Korean Assoc Maxillofac Plast Reconstr Surg2008;30(6):540-5

12. Se-Hoon Kahm, Yong-Chul Bae, Seok-Gyu Kim, Je-Uk Park. Determination of Implant Loading Timing in Human: A Pilot Study.Scientific Poster, 17th Congress of EAO 2008

13. Tae-Gwan Eom, In-Hee Cho, Myung-Duk Kim, Young-Seok Cho, Kyoo-Ok Choi. Effects of Final Drill Diameter Size on Bone Formationin the Mandible of Micropig. Scientific Poster, 17th Congress of EAO 2008

14. Soo-Young Bae, Su-Kyoung Kim, Eun-Jung Kang, Young-Bae An, Gyu-Sub Eom, Tae-Gwan Eom. The Effect of Hydroxyapatite-blastedTitanium Surface Roughness on Osteoblast-like Cell Line MG-63. Scientific Poster, Meeting of the Korean Society for Biomaterials2008

15. Jae-Wan Park, Min-Suk Kook, Hong-Ju Park, Uttom Kumar Shet, Choong-Ho Choi, Suk-Jin Hong, Hee-Kyun Oh. Comparative Study ofRemoval Effect on Artificial Plaque from RBM Treated Implant. J Korean Assoc Maxillofac Plast Reconstr Surg 2007;29(4):309-20

16. Su-Yeon Cho, Hye-Ran Jeon, Sun-Kyoung Lee, Seoung-Ho Lee, Jun-Young Lee, Keum-Ah Han. The Effect of Ca-P Coated BovineMineral on Bone Regeneration around Dental Implant in Dogs. J Korean Acad Periodontol 2006;36(4):913-23

17. Pil-Kwy Jo, Seung-Ki Min, Kyung-Hwan Kwon, Young-Jo Kim. Scanning Electron Microscopic Study of Implant Surface afterEr,Cr:YSGG Laser Irradiation. J Korean Assoc Maxillofac Plast Reconstr Surg 2006;28(5):454-69

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ObjectiveGiven that the orientation of the transducer (mesiodistal orbuccolingual) affects the data obtained from a piezoelectricresonance frequency analysis (RFA), this study evaluatedwhether it is necessary to use measurements taken in twodifferent directions (mesiodistal and buccolingual) when usingmagnetic RFA to assess changes in the stiffness of dentalimplants.

Materials & MethodsA prospective clinical trial was completed, in a total of 53patients, on 71 non-submerged dental implants that wereinserted to replace the unilateral loss of mandibular molars.All of the implants were of the same diameter (4.1 mm),length (10 mm), and collar height (2.8 mm). The implantstability quotient (ISQ) was measured during the surgicalprocedure, and at 4 and 10 weeks after surgery.Measurements were taken twice in each direction: in thebuccolingual direction from the buccal side and in themesiodistal direction from the mesial side. The average oftwo measurements in each direction was regarded as therepresentative ISQ of that direction. The higher and lowervalues of the two ISQs (buccolingual and mesiodistal) werealso classified separately. In addition, the variation in ISQ wasquantified by subtracting the lower value from the highervalue, and the implants were classified into two groupsaccording to this variation: one with ISQ variation of 3 ormore and the other with a variation of <3.

Results There were no differences between the two ISQs whenmeasured from different directions, but there were significantdifferences between the higher and lower values of the ISQsat each measurement point. A significant difference was alsoobserved between the two ISQ variation groups in thepattern of change of the lower value for the period fromimmediately after surgery to 10 weeks after surgery.

ConclusionsAcquisit ion of two directional measurements andclassification of the higher and lower values of the twodirectional ISQs may allow clinicians to detect patterns ofchange in ISQ that would not be identified if only onedirectional measurement were made.

A Comparison of Implant Stability Quotients Measured Using Magnetic Resonance Frequency Analysis from Two Directions: Prospective Clinical Study During the Initial Healing Period

Table 1. The change in implant stability quotient (ISQ) discrepancymeasured from two different directions at each measurement timepoint

Diameter ISQ discrepancy* (mean SD) P-value**

* ISQ discrepancies were calculated by subtracting the BL from the MD at each time point.** P-values were calculated for differences between two time points (during surgery and at

postoperative week 10) using a Wilcoxon’s signed-ranks test.

Straumann (N=25)During surgery

At post-operative week 10

1.1 ± 2.720.42 ± 1.48

0.16

Osstem SSII (N=28)During surgery

At post-operative week 10

0.36 ± 3.6-0.14 ± 1.54

0.317

Fig. 1. The comparison of the pattern of change in the implant stability quotient(ISQs) obtained from the four measures from surgery to 10 weeks aftersurgery. 3+Group=the group with ISQ variation of 3 or more.3-Group, the group with ISQ variation of <3. (a) Pattern of change of MN. (b) Pattern of change of MX. (c) Pattern of change of BL. (d) Pattern of change of MD.

ObjectiveThe purpose of the present study was to analyze the implantstability quotient (ISQ) values for Korean non-submerged typeimplant and determine the factors that affect implant stability.

Materials & MethodsA total of 49 Korean non-submerged type implants wereinstalled in 24 patients, and their stability was measured byresonance frequency analysis (RFA) at the time of surgery,and 1, 2, 3, 4, 8, 12 weeks postoperatively. The data forimplant site, age, sex, implant length and diameter, graftperforming, bone type, and insertion torque were analyzed.

Results The lowest mean stability measurement was at 3 weeks.There was significant difference between implant placementand 12 weeks. There was significant difference betweenimplant placement and 12 weeks in diameters of 4.1 mm and4.8 mm. Also, there were significant differences betweendiameters of 4.1 mm and 4.8 mm at implant placement and12 weeks after surgery. This result suggests that the factorrelated to implant diameter may affect the level of implantstability. No statistically significant relationship was foundbetween the resonance frequency analysis and the variablesof maxilla/mandible, sex, anterior/posterior, implant length,age of patient, graft performing, bone type, insertion torqueduring initial healing period.

Conclusions These findings suggest that the factor related to implantdiameter may affect the variance of implant stability, and ISQvalue of implant was stable enough for proved stability levelduring initial healing period.

Non-Submerged Type Implant Stability Analysis During Initial Healing Period by Resonance Frequency Analysis

Fig. 1. Change in the mean ISQ values during healing up to 12 weeks.* : Statistically significant change compared to surgery (P < 0.05)

Fig. 2. Evaluation of implant stability between implant placement and 12 weeks forimplant placed in the maxilla and in the mandible.* : Statistically significant difference between maxilla and mandible (P < 0.05)

* : Statistically significant effective factor for rate of change between surgery and 3months (P < 0.05)

Table 1. Statistical Rate of Change Date for ISQ Values for DifferentVariables

Diameter P value

Maxilla/Mandible 0.6141 > 0.05

Sex 0.9918 > 0.05

Anterior/Posterior 0.8408 > 0.05

Length 0.6317 > 0.05

Diameter 0.0092 < 0.05

Age 0.3836 > 0.05

Graft 0.9635 > 0.05

Bone type 0.8354 > 0.05

Insertion torque 0.0675 > 0.05

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ObjectiveThis study compared the implant stability and clinicaloutcomes obtained with two types of non-submerged dentalimplant that have different thread designs and surfacetreatments.

Materials & Methods A randomized clinical trial with one year of follow-up wasperformed on 56 participants with 75 implants (control group,36 implants in 28 subjects; experimental group, 39 implantsin 28 subjects). The experimental group received the OsstemSSII Implant system; the control group received the StandardStraumann� Dental Implant System.The diameter and lengthof the fixture were uniform at 4.1 mmr and 10 mm and all theimplants restored the unilateral loss of one or two molarsfrom the mandible. To compare implant stability, the peakinsertion torque, implant stability quotient (ISQ), and periotestvalue (PTV) were evaluated during surgery, and at 4 and 10weeks after surgery. To compare marginal bone loss,standard periapical radiographs were obtained duringsurgery, and at 10 weeks and one year after surgery.

Results This study showed statistically significant differences betweenthe two groups in peak insertion torque (p = .009) and ISQ (p= .003) but not in PTV (p = .097) at surgery. In contrast, therewas no statistically significant difference in the pattern ofchange of ISQ during the 10 weeks after surgery (p = .339).For marginal bone loss, no significant difference wasobserved between the control and experimental groupsbefore functional loading (p = .624), but after one year offollow-up, a borderline difference was noted (p= .048).

Conclusions The success rate after one year of follow-up was 100% forboth systems of implant, despite there being significantdifference in implant stability during surgery. There was aborderline difference in marginal bone loss after one year offollow-up.

A Randomized Clinical 1-year Trial Comparing Two Types of Non-Submerged Dental Implant

Table 1. Comparison of marginal bone loss between the two implants

Type of Implant

Duration

During the10 weeksafter surgery

One yearfollow-up

Area� N Mean ± SD (mm) N Mean ± SD (mm) p value*

Standard Straumann� Dental Implant system Osstem SSII Implant system

Proximal 25 0.96 ± 0.64 28 0.75 ± 0.49 .273

Distal 25 0.62 ± 0.44 28 0.60 ± 0.51 .722

Avg � 25 0.79 ± 0.51 28 0.67 ± 0.43 .624

Proximal 24 1.21 ± 0.57 26 0.92 ± 0.68 .066

Distal 24 0.93 ± 0.39 26 0.65 ± 0.37 .013

Avg 24 1.07 ± 0.46 26 0.79 ± 0.42 .048

* The p values were calculated using Mann - Whitney test.

� Area means the radiographic measurement area for calculation of marginal bone loss.

�Avg means the average value of proximal and distal bone loss.

ObjectiveThe objective of this study was to evaluate the peri-implant’shard and soft tissue response associated with the 1-stage,nonsubmerged, endosseous dental implant.

Materials & MethodsA multicenter retrospective clinical evaluation was performedon 339 nonsubmerged implants placed in 108 patients at 5clinical centers between January 2003 and December 2007.

Results After a mean follow-up period of 30 months, the mean crestalbone resorption in 339 implants was 0.43 mm. The survivaland success rates were observed to be 99.1% and 95.1%,respectively. The mean calculus, inflammatory, and plaqueindices were 0.13, 0.37, and 0.73, respectively, and themean width of buccal keratinized mucosa was observed tobe 2.43 mm.

Conclusions The short- to intermediate-term evaluation of the 1-stage,nonsubmerged, endosseous implant yields relatively highsurvival and success rates.

Evaluation of Peri-Implant Tissue in Nonsubmerged Dental Implants: A Multicenter Retrospective Study

Table 1. Crestal bone resorption

Bone resorption No. of implants

None 198

0.1~0.5 mm 10

0.6~1.0 mm 81

1.1~2.0 mm 7

~2.0 mm 8

Total 304*

*Not specified for 35 implants.

Table 2. Implant failure and survival by year

YearNo. implants

at start of yearNo. implants survival

at follow-upFailures Survival,%

1 339 336 3 99.1

2 336 336 0 100

3 336 336 0 100

Fig. 1. Periapical radiograph taken immediately after implant placement. In the #36 area,an implant, 4.8 mm in diameter and 10 mm in length, was placed. The crestalbone level in the vicinity of implant was considered as the baseline.

Fig. 2. Periapical radiograph taken 1 year after implant placement.Based on the baseline, the crestal bone level on the radiograph taken immediatelyafter surgery, from mesial side (a) and distal side (b), the vertical length to the firstimplant-bone contact area was measured and added by referring to themagnification rate and 0.8 mm pitch, and the average was obtained. In this case,a=0.8 mm and b=1.2 mm, and after 1 year; the mean amount of crestal boneresorption was 1.2 mm.

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Implant-supported fixed and removable prostheses provide aproper treatment modality with reliable success.The SSII implants is a one-stage nonsubmerged threadedtitanium implants with Resorbable Blasting Media (RBM)surface developed by Osstem implant (Seoul, Korea) inOctober of 2002.

This study is to evaluate the survival rate of the SSII implantsfor 4 years using radiographic parameters and to review theretrieved implants by the cytotoxicity tests.

Since September 2003. 439 SSII implants had been used for173 patients at Ewha Women University Medical Center inKorea. Patients consisted of 91 females (52.6 %) and 82males (47.4 %). The patients' mean age was 42 ±16 years.ranging from 21 to 83 years. The follow-up period rangedfrom 9 to 46 months (mean F/U 24.2 ± 10.2 months).

The results are as follows:

1. Of 439 implants, 17 implants were removed and 4-yearcumulative survival rate was 96.1%.

2. 82.3% of 17 failed implants were founded during healingphase, and 94.1% of failed fixtures were removed within 5months after implantation.

3. Crestal bone around the implants was resorbed to 1mrn in89.0%. to 1-2 mm loss of the marginal bone in 8.3%. andthe bone loss over 2 mm was occured in 2.7%.

4. Microscopic examination of the retr ieved implantsdisclosed Grade 0 cytotoxicity in 4 and Grade 1cytotoxicity in 2 of 6 groups divided according to lotnumbers. Inhibit ion rate with optical density wasacceptable as low as ISO standard.

Four-Year Survival Rate of RBM Surface Internal Connection Non-Submerged Implants and the Change of the Peri-Implant Crestal Bone

Fig. 1. A computer-assisted calibration was carried out for each single site by evaluatingthe given distance between several threads (pitch: 0.8 mm).

Fig. 2. The 4-year cumulative survival rate: (p > .05).

94.7

0 12 24 36 48

96.1

97.0

TotalMxMn

Surv

ival

(%

)

Months

100.0

97.5

95.0

92.5

90.0

Influence of Abutment Connections and Plaque Control on the Initial Healing of Prematurely Exposed Implants: An Experimental Study in Dogs

Table 1. Parameters (mm; mean ± SD) of bone height during the healing periodin abutment-connected and partially exposed dental implant groups

Partiallyexposed sites

Abutment-connected sites P values

Plaque control 10.1 ± 0.5 9.3 ± 0.5 < .05

No plaque control 6.5 ± 0.7 8.2 ± 0.6 < .05

ObjectiveSpontaneous early implant exposure is believed to beharmful, result ing in early crestal bone loss aroundsubmerged implants. The purpose of this study was toexamine the influence of abutment connections and plaquecontrol on the initial healing of prematurely exposed implantsin the canine mandible.

Material & MethodsBilateral, edentulated, flat alveolar ridges were created in themandible of 10 mongrel dogs. After 3 months of healing, twoimplants were placed on each side of the mandible followinga commonly used two-stage surgical protocol. Implants oneach side were randomly assigned to one of two procedures:1) connection of a cover screw to the implant and removal ofthe gingiva to expose the cover screw; and 2) connection ofa healing abutment to the implant so that the coronal portionof the abutment remained exposed to the oral cavity. In fivedogs (plaque control group), meticulous plaque control wasperformed. In the other five dogs (no plaque control group),plaque was allowed to accumulate. At 8 weeks post-implantation, microcomputed tomography was performed atthe implantation site to measure bone height in the peri-implant bone.

ResultsThe plaque control group had greater vertical alveolar ridgeheight (9.7 ± 0.5 mm) than the group without plaque control(7.4 ± 0.7 mm; p < .05). In the plaque control group, theaverage bone height was greater with the abutment-connected implant (10.1 ± 0.5 mm) than with the partiallyexposed implant (9.3 ± 0.5 mm; p < .05). In the groupwithout plaque control, the average bone height was greaterwith the partially exposed implant (8.2 ± 0.6 mm) than withthe abutment-connected implant (6.5 ± 0.7 mm; p < .05).

ConclusionsThese results suggest that the placement of healingabutments and meticulous plaque control may limit bone lossaround submerged implants when implants are partiallyexposed.

Fig. 1. A) Three-dimensional micro-CT of an abutment-connected implant from theplaque control group demonstrating bone (yellow) around the implants (gray). B) Three-dimensional micro-CT of a partially exposed implant from the plaquecontrol group demonstrating bone (yellow) around the implants (gray).

Fig. 2. A) Three-dimensional micro-CT of an abutment-connected implant from the groupwithout plaque control demonstrating bone (yellow) around the implants (gray). B) Three-dimensional micro-CT of a partially exposed implant from the groupwithout plaque control demonstrating bone (yellow) around the implants (gray).

A B

A B

Buccal Lingual Buccal Lingual


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Table 1. Parameters of bone-to-implant contact and bone height around dentalimplants when placed either without or with a flap

Flapless group Flap group

Bone-implant contact (%) 70.4 ± 6.3 59.5 ± 6.3

Bone height (mm) 10.1 ± 0.5 9.0 ± 0.7

ObjectiveThe purpose of this study was to examine the effect off lapless implant surgery on crestal bone loss andosseointegration in a canine mandible model.

Materials & MethodsIn 6 mongrel dogs, bilateral, edentulated, flat alveolar ridgeswere created in the mandible. After 3 months of healing, 2implants in each side were placed by either flap or flaplessprocedures. After a heal ing period of 8 weeks,microcomputerized tomography at the implantation site wasperformed. Osseointegration was calculated as percentageof implant surface in contact with bone. Additionally, boneheight was measured in the peri-implant bone.

Results The mean osseointegration was greater at flapless sites(70.4%) than at sites with flaps (59.5%) (p < .05). The meanperi-implant bone height was greater at flapless sites (10.1mm) than at sites with flaps (9.0 mm) (p < .05).

ConclusionsFlapless surgery can achieve results superior to surgery withreflected flaps. The specific improvements of this techniqueinclude enhanced osseointegration of dental implants andincreased bone height.

Flapless Implant Surgery: An Experimental Study

Fig. 1. Clinical feature after implant placement. A: Flapless surgeryB: Flap surgery

Fig. 2. Three-dimensional micro-CT showing the bone (yellow) around theimplants (gray).

A: Flapless surgery

Buccal side lingual side

B: Flap surgery

Buccal side lingual side

Fig. 3. Three-dimensional micro-CT overview of the bone-to implant contact area (red)around the implant surface (gray).

A: Flapless surgery B: Flap surgery

Table 1. Parameters (mean values and standard deviations) of bone-to-implant contact and bone height around dental implants witheither immediate or delayed loading

DelayedImmediately P values

Bone-implant contact (%) 60.9 ± 8.2 65.5 ± 8.8 < .05

Bone height (mm) 9.6 ± 0.5 10.6 ± 0.4 < .05

ObjectiveThe aim of this study was to compare the peri-implant bonereactions of implants subjected to immediate loading withthose subjected to delayed loading.

Materials & MethodsIn 6 mongrel dogs, bilateral edentulated flat alveolar ridgeswere created in the mandible. After 3 months of healing, 1implant was placed in each side. On one side of themandible, the implant was loaded immediately with a force of20N that was applied at a 120。angle from the tooth’slongitudinal axis at the labial surface of the crown for 1,800cycles per day for 10 weeks. On the opposite side, after adelay of 3 months to allow osseointegration to take place, theimplant was loaded with the same force used for theimmediately loaded implant. Ten weeks after loading,microscopic computerized tomography at the implantationsite was performed. Osseointegration was calculated as thepercentage of implant surface in contact with bone. Boneheight was measured in the peri-implant bone.

Results The mean osseointegration was greater (65.5%) for thedelayed-loading implants than for the immediately loadedimplants (60.9%; p < .05). The mean peri-implant boneheight was greater (10.6 mm) for the delayed-loadingimplants than for the immediately loaded implants (9.6 mm; p< .05).

ConclusionsThe results indicate that when implants are immediatelyloaded, the immediate loading may decrease bothosseointegration of dental implants and bone height.

Peri-Implant Bone Reactions at Delayed and Immediately Loaded Implants: An Experimental Study

Fig. 1. Three-dimensional micro-CT showing the bone (yellow) and the bone-to-implantcontact area (red) around the implants (gray): A, immediately loaded implant; B, delayed loading implant. Buccal, buccal side of the alveolus; lingual, lingualside of the alveolus.

A B


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ObjectiveOne of the common problems of dental implant prosthesis isthe loosening of the screw that connects each component,and this problem is more common in single implant-supported prostheses with external connection and inmolars.The purposes of this study were: (1) to compare the initial abutment screw de torque values ofthe six different implant-abutment interface designs, (2) tocompare the detorque values of the six different implant-abutment interface designs after cyclic loading, (3) tocompare the detorque values of regular and wide diameterimplants and (4) to compare the initial detorque values withthe detorque values after cyclic loading.

Material & MethodsSix different implant-abutment connection systems wereused. The cement retained abutment and titanium screw ofeach system were assembled and tightened to 32 Ncm withdigital torque gauge. After 10 minutes, initial detorque valueswere measured. The custom titanium crown were cementedtemporarily and a cyclic sine curve load (20 to 320 N, 14 Hz)was applied. The detorque values were measured after cyclicloading of one million times by loading machine. One-wayANOVA test, scheffe's test and Mann-Whitney U test wereused.

The Effect of Internal Implant-Abutment Connection and Diameteron Screw Loosening

Chun-Yeo Ha, Chang-Whe Kim,Young-Jun Lim, Kyung-Soo JangJ Kor Acad Prosthodont 2005;43(3):379-92

Fig. 1. Regular diameter implants,abutments, abutmentscrews and titaniumcrowns.

Fig. 2. Wide diameter implants,abutments, abutmentscrews and titaniumcrowns.

Results & ConclusionsThe results were as follows:1. The initial detorque values of six different implant-abutment

connections were not significantly different (p > .05).2. The detorque values after one million dynamic cyclic

loading were significantly different (p < .05).3. The SSII regular and wide implant both recorded the

higher detorque values than other groups after cyclicloading (p < .05).

4. Of the wide the initial detorque values of Avana SelfTapping Implant, MIS and Tapered Screw and thedetorque values of MIS implant after cyclic loading werehigher than their regular counterparts (p < .05).

5. After cyclic loading, SSII regular and wide implants showedhigher de torque values than before (p < .05).

Ext(R)

Ext(W)

Hexed, collar 1mm, height 5.5mm

Hexed, collar 1mm, height 5.5mmOsstem USII Implant

Int1(R)

Int1(W)

Ext : extenal, Int : intenal

non-octa, height 5.5mm

non-octa, height 5.5mmOsstem SSII Implant

Int2(R)

Int2(W)

trivam, gingival collar 1.5mm

trivam, gingival collar 1.5mmCamlog�

Int3(R)

Int3(W)

non-hex, gingival collar 1.0mm

non-hex, gingival collar 1.0mmImplantium�

Int4(R)

Int4(W)

hexed, gingival collar 2.0mm

hexed, gingival collar 2.0mmMIS�

Int5(R)

Int5(W)

hexed, 5.5mm wide profile

hexed, 5.5mm wide profileTapered Screw Vent�

Group Brand name Types of cemented abutments

Table 1. List of Components

Fig. 3. Mean initial detorque value. Fig. 4. Mean detorque values aftercyclic loading.

Fig. 5. Mean detorque values ofregular diameter implants.

Fig. 6. Mean detorque values of widediameter implants.

1. In-Ho Cho, Jae-Hoon Lee, Young-Gyun Song, Young-Mi Kim, So-Young Jeon, Evaluation on the efficacy and safety of calciummetaphosphate coated fixture. J Adv Prosthodont 2013;5:172-8

2. Kyu-Hong Jo, Kyu-Ho Yoon, Jeong-Kwon Cheong, In-Seong Jeon. Postoperative perforation of the Schneiderian membrane in maxillarysinus augmentation: a case report. J Oral Implantol. 2012 Apr 16. [Epub ahead of print]

3. Kyu-Hong Jo, Kyh-Ho Yoon, Kwan-Soo Park, Jung-Ho Bae, Kyung-Ha You, Ji-Hoon Han, Jae-Myung Shin, Jee-Seon Baik, In-Seong Jeon,Jeong-Kwon Cheong. Thermally induced bone necrosis during implant surgery : 3 case reports. J Korean Assoc Oral Maxillofac Surg2011;37:406-14


5. Jong-Chul Park, Hyun-Duck Kim, Soung-Min Kim, Myung-Jin Kim, Jong-Ho Lee. A Comparison of Implant Stability Quotients MeasuredUsing Magnetic Resonance Frequency Analysis from Two Directions: Prospective Clinical Study during the Initial Healing Period. Clin.Oral Impl. Res. 2010;21(6):591-7

6. Young-Kyun Kim, Bum-Soo Kim, Hyo-Jung Lee, Jung-Won Hwang, Pil-Young Yun. Surgical Repositioning of an Unrestorable ImplantUsing a Trephine Bur: A Case Report. Int J Periodontics Restorative Dent. 2010 Mar-Apr;30(2):181-5

7. Deug-Han Kim, Eun-Kyoung Pang, Chang-Sung Kim, Seong-Ho Choi, Kyoo-Sung Cho. Non-submerged type Implant Stability Analysisduring Initial Healing Period by Resonance Frequency Analysis. J Korean Acad Periodontol 2009;39(3):339-48

8. Chae-Su Lim, Min-Seok Oh, Su-Gwan Kim, Jin-Sung Park, Seo-Yoon Kim, Ka-Young Seol. Prospective Clinical Trial of Survival Rate forTwo Different Implant Surfaces Using the Osstem SSII Non-submerged Implant System in Partially Edentulous Patients. J Kor Dent Sci.2009;3(1):35-41

9. Young-Kyun Kim, Su-Gwan Kim, Hee-Kyun Oh, Yong-Geun Choi, Yong-Seok Cho, Young-Hak Oh, Jun-Sik Son. Evaluation of Peri-implantTissue in Nonsubmerged Dental Implants: a Multicenter Retrospective Study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2009;108(2):189-95

10. Jong-Chul Park, Seung-Ryong Ha, Soung-Min Kim, Myung-Jin Kim, Jai-Bong Lee, and Jong-Ho Lee. A Randomized Clinical 1-year TrialComparing Two Types of Non-submerged Dental Implant. Clin Oral Impl Res 2010;21(2):228-36

11. Young-Kyun Kim, Pil-Young Yun, Su-Gwan Kim, Bum-Soo Kim, Joo L Ong. Evaluation of Sinus Bone Resorption and Marginal BoneLoss after Sinus Bone Grafting and Implant Placement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e21-8

12. Hye-Ran Jeon, Myung-Rae Kim, Dong-Hyun Lee, Jung-Sub Shin, Nara-Kang. Four-year Survival Rate of RBM Surface InternalConnection Non-Submerged Implants and the Change of the Peri-Implant Crestal Bone. J Korean Assoc Maxillofac Plast Reconstr Surg2009;31(3):237-42

13. In-Seong Jeon. Clinical Application of Osstem SSIII Implant System. J Korean Dental Success 2009;29(8):829-37



16. Sung-Moon Back, Min-Suk Oh, Su-Kwan Kim. A Retrospective Study on the Clinical Success Rate of Osstem Implant. Key EngineeringMaterials 2008;361-363:1331-4

17. Su-Gwan Kim, Daniel Sun-Ho Oh. Placement of Calcium Metaphosphate-coated Dental Implants in the Posterior Maxilla: Case Reports.Hosp Dent (Tokyo)2008;20(1):39-43

18. Hong-Ju Park, Min-Suk Kook, Su-Gwan Kim, Young-Kyun Kim, Yong-Seok Cho, Gab-Lim Choi, Young-Hak Oh, Hee-Kyun Oh.Multicenter Retrospective Study of Immediate Two Different RBM Surfaced Implant Systems after Extraction. J Korean AssocMaxillofac Plast Reconstr Surg 2008;30(3):258-65

19. Min-Suk Kook, Hong-Ju Park, Su-Gwan Kim, Young-Kyun Kim, Yong-Seok Cho, Gab-Lim Choi, Young-Hak Oh, Hee-Kyun Oh. ARetrospective Multicenter Clinical Study of Installed USII / SSII Implants after Maxillary Sinus Floor Elevation. J Kor Oral Maxillofac Surg2008;34:341-9


21. Young-Kyun Kim, Pil-Young Yun, Min-Jung Kwon. Short term Retrospective Clinical Study on GSII, SSIII, USIII. J KoreanImplantology(KAOMI) 2008;12(2):12-22

22. Ju-Hyon Lee, Hyun-Gi Min, Jin-Sook Lee, Myung-Rae Kim, Na-Ra Kang. Resonance Frequency Analysis in Non-Submerged, InternalType Implant with Sinus Augmentation Using Deproteinized Bovine Bone Mineral. J Korean Assoc Maxillofac Plast Reconstr Surg2008;30(6):554-60


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24. Young-Kyun Kim, Hee-Kyun Oh, Su-Gwan Kim, Yong-Geun Choi, Yong-Seok Cho, Young-Hak Oh. Multicenter Retrospective ClinicalStudy of Osstem SSII Implant System. J Korean Implantology(KAOMI) 2007;11(1):20-31

25. Jong-Jin Kwon. For whom? Immediate Implant: The Factors for Successful Immediate Implant. J Korean Cilnical Implant2007;35(5):20-38

26. Jong-Jin Kwon, Tae-Sung Kim. Retrospective Study of Immediately Loaded Implants among Elderly Patients with Diabetes Mellitus.Scientific Oral, 46th Congress of the Korean Assoc Maxillofac Plast Reconstr Surg 2007

27. Min-Seok Oh, Su-Gwan Kim, Hak-Kyun Kim, Seong-Yong Moon. Prospective Clinical Study of Two Osstem SSII Implant Systems withDifferent Surfaces in Partially Edentulous Patients. Scientific Oral, 2nd Congress of the ICOI Korea 2007



30. Young-Kyun Kim, Jung-Won Hwang, Pil-Young Yun, Su-Gwan Kim, Chae-Heon Chung, Yong-Gun Choi, Sung-Il Song. MulticentricProspective Clinical Study of Korean Implant System: Early Stability Measured by Periotest. J Korean Dent Assoc 2004;42(12):873-81

SS SYSTEM References

1. Ki-Seong Kim, Young-Jun Lim, Myung-Joo Kim, Ho-Beom Kwon, Jae-Ho Yang, Jai-Bong Lee, Soon-Ho Yim. Variation in the TotalLengths of Abutment/Implant Assemblies Generated with a Function of Applied Tightening Torque in External and Internal Implant-Abutment Connection. Clin. Oral Impl. Res. 2011;22:834-9


3. Hyon-Mo Shin, Chang-Mo Jeong, Young-Chan Jeon, Mi-Jeong Yun, Ji-Hoon Yoon. Influence of Tightening Torque on Implant-AbutmentScrew Joint Stability. J Kor Acad Prosthodont 2008;46(4):396-408

4. Chun-Yeo Ha, Chang-Whe Kim, Young-Jun Lim, Myung-Joo Kim. Effect of Casting Procedure on Screw Loosening of UCLA Abutment inTwo Implant-Abutment Connection Systems. J Kor Acad Prosthodont 2008;46(3):246-54

5. Ho-Yeon Won, In-Ho Cho, Joon-Seok Lee. A Study of SmartpegTM’s Lifetime according to Sterilization for Implant Stability. J Kor AcadProsthodont 2008;46(1):42-52


7. Chun-Yeo Ha, Chang-Whe Kim, Young-Jun Lim, Myung-Joo Kim, Ho-Bum Kwon. The Influence of Abutment Angulation on ScrewLoosening of Implant in the Anterior Maxilla. Scientific Poster, J Kor Acad Prosthodont 2008 Conference

8. Si-Yeob Kim, Byung-kook Kim, Jin-Ho Heo, Ju-Youn Lee, Chang-Mo Jeong, Yong-Deok Kim. Evaluation of Stability of Double ThreadedImplant-Emphasis on Initial Stability Using Osstell MentorTM; Part I. J Kor Acad Stomatog Func Occlusion 2007;23(4):327-36

9. Jung-Bo Huh, Sok-Min Ko. The Comparative Study of Thermal Inductive Effect Between Internal Connection and External ConnectionImplant in Abutment Preparation. J Kor Acad Prosthodont 2007;45(1):60-70


11. Chae-Heon Chung. Detorque Force of TiN-coating Abutment Screw with Various Coating Thickness After Repeated Closing andOpening. Scientific Oral, 12th International College of Prosthodontists Meeting




15. Byung-Kook Kim, Tae-Gwan Eom, Kyu-Ok Choi, Lee GH. Correlation Between Insertion Torque and Primary Stability of Dental Implantby Block Bone Test. Scientific Poster, 15th Congress of EAO 2006

16. Chun-Yeo Ha, Chang-Whe Kim, Young-Jun Lim, Kyung-Soo Jang. The Effect of Internal Implant-Abutment Connection and Diameter onScrew Loosening. J Kor Acad Prosthodont 2005;43(3):379-92



19. Ji-Hoon Yoon, Chang-Mo Jeong, Tae-Gwan Eom, Mi-Hyun Cheon. Effect Joint Design on Static and Dynamic Strength. ScientificPoster, 14th Congress of EAO 2005

20. Tae-Hee Byun, Kwang-Hoon Kim. Study on the Adaptation to the Investment Water-Powder Ratio by Abutment and Casting Crown.Scientific Poster, Kor Dent Technician Associate 2005 Conference

21. Byung-Gi Cho, Jae-Ho Ryu. Study of Possibility Direct Casting on Titanium Abutment. Scientific Poster, Kor Dent Technician Associate2005 Conference

22. Byung-Soo Bae, Jae-Ho Ryu. Investigation of the Resin Adhesion and Task Convenience for Surface Shape. Scientific Poster, Kor DentTechnician Associate 2005 Conference


1. Al-Marshood MM, Junker R, Al-Rasheed A, Al Farraj, Aldosari A, Jansen JA, Anil S. Study of the Osseointegration of Dental ImplantsPlaced with an Adapted Surgical Technique. Clin. Oral Impl. Res. 2011;22:753-9

2. In-Hee Cho, Hong-Young Choi, Yong-Seok Cho, Tae-Gwan Eom. Histomorphometric and Fluorescence Microscopic Evaluation ofInterfacial Bone Formation around Different Dental Implants. Scientific Poster, 19th Congress of EAO 2010

3. Woo-Jin Jeon, Su-Gwan Kim, Sung-Chul Lim, Joo L. Ong, Daniel Sunho Oh. Histomorphometric Evaluation of Immediately Loaded SSIIImplants of Different Surface Treatments in a Dog Model. J Biomed Mater Res 2009;90A:396-400

4. Joo-Young Lee, Su-Gwan Kim, Seong-Yong Moon, Sung-Chul Lim, Joo L. Ong, Kwang-Min Lee. A Short-term Study on ImmediateFunctional Loading and Immediate Nonfunctional Loading Implant in Dogs: Histomorphometric Evaluation of Bone Reaction. Oral SurgOral Med Oral Pathol Oral Radiol Endod 2009;107:519-24

5. Se-Hoon Kim, Byung-Ho Choi, Jingxu Li, Han-Sung Kim, Chang-Yong Ko, Seung-Mi Jeong, Feng Xuan, Seoung-Ho Lee. Peri-implantBone Reactions at Delayed and Immediately Loaded Implants: An Experimental Study. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 2008;105:144-8

6. Sung-Han Sul, Byung-Ho Choi, Jingxu Li, Seung-Mi Jeong, Feng Xuan. Histologic Changes in the Maxillary Sinus Membrane after SinusMembrane Elevation and the Simultaneous Insertion of Dental Implants without the Use of Grafting Materials. Oral Surg Oral Med OralPathol Oral Radiol Endod 2008;105:e1-5

7. Sung-Han Sul, Byung-Ho Choi, Jingxu Li, Seung-Mi Jeong, Feng Xuan. Effects of Sinus Membrane Elevation on Bone Formation aroundImplants Placed in the Maxillary Sinus Cavity: An Experimental Study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:684-7

8. Byung-Ho Choi, Jingxu Li, Han-Sung Kim, Chang-Yong Ko, Seung-Mi Jeong, Feng Xuan. Comparison of Submerged and NonsubmergedImplants Placed without Flap Reflection in the Canine Mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:561-5

9. Seung-Mi Jeong, Byung-Ho Choi, Jingxu Li, Han-Sung Kim, Chang-Yong Ko, Seoung-Ho Lee. Influence of Abutment Connections andPlaque Control on the Initial Healing of Prematurely Exposed Implants: An Experimental Study in Dogs. J Periodontol 2008;79(6):1070-4

10. Soo-Young Bae, Su-Kyoung Kim, Eun-Jung Kang, Young-Bae An, Gyu-Sub Eom, Tae-Gwan Eom. The Effect of Hydroxyapatite-blastedTitanium Surface Roughness on Osteoblast-like Cell Line MG-63. Scientific Poster, Meeting of the Korean Society for Biomaterials 2008

11. Seung-Mi Jeong, Byung-Ho Choi, Jingxu Li, Han-Sung Kim, Chang-Yong Ko, Jae-Hyung Jung, Hyeon-Jung Lee, Seoung-Ho Lee,Wilfried Engelke. Flapless Implant Surgery: An Experimental Study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:24-8

12. Seoung-Ho Lee, Byung-Ho Choi, Jingxu Li, Seung-Mi Jeong, Han-Sung Kim, Chang-Yong Ko. Comparison of Corticocancellous Blockand Particulate Bone Grafts in Maxillary Sinus Floor Augmentation for Bone Healing around Dental Implants. Oral Surg Oral Med OralPathol Oral Radiol Endod 2007;104(3):324-8


14. Ki-Jong Sun, Jae-Young Park, Eun-Gyeong Jung, Mee-Ran Shin, Yun-Sang Kim, Sung-Hee Pi, Hyung-Shik Shin, Hyung-Keun You.Comparative Study of Osseointegration on Different Immediate Implants in Extraction Sockets of Beagle Dogs. J Korean AcadPeriodontol 2007;37(2):209-21

15. Young-Jong Kim, Su-Gwan Kim, Young-Kyun Kim, Suk-Young Kim. Analysis of Failed Implants. J Korean Implantology (KAOMI)2007;11(3):46-58


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ObjectiveThe aim of this study was to evaluate the clinical value ofOsstem USII Plus system implants. Clinical and radiographicdata were analyzed for 88 implants placed and functionallyloaded for a 12 month period at the Yonsei University DentalHospital.

Materials & MethodsBased on the patient's medical records, clinical factors andtheir effects on implant marginal bone resorption, distributionand survival rate were analyzed. The marginal bone loss wasevaluated at implant placement and during a 6 to 12 monthsfunctional loading period. The independent sample t-test wasused to evaluate the interrelationship between the factors (α=0.05), and one way repeated measures ANOVA was usedto compare the amount of marginal bone resorption.

Results

The cumulative survival rate for 88 implants was 100%. Themarginal bone resorption from implant placement toprosthetic delivery was 0.24 mm and the average marginalbone resorption from prosthetic delivery to 12 months offunctional loading was 0.19 mm. The total average boneresorption from implant placement to 12 months of functionalloading was 0.43 mm. There were no statistically differencesin the amount of marginal bone resorption when implantswere placed in the maxilla or the mandible (p>.05), however,implants placed in the posterior areas showed significantlymore marginal bone loss than those placed in the anteriorareas (p<.05).

ConclusionsBased on these results, the short term clinical success rate ofRBM surface treated external connection domestic implantsshowed satisfactory results and the marginal bone loss was inaccord with the success criteria of dental implants.

Success Rate and Marginal Bone Loss of Osstem USII Plus Implants: Short Term Clinical Study

ObjectiveBone density is one of the important factors for the long termsuccess of endosseous implants. The bone density variesfrom site to site and from patient to patient. A preoperativeevaluation of the bone density is quite useful to oral surgeonsfor planning dental implantation. More accurate informationon the bone density will help surgeons identify suitableimplant sites, thereby increase the success rate of dentalimplantation.This study examined the correlation between the bonedensity measured preoperatively by computed tomography(CT) and the implant primary stability measured by resonancefrequency analysis. Furthermore, the effects of the implantsites, gender, age and generalized systemic disorder patientson the bone density and primary implant stability wereexamined.

Materials & MethodsOne hundred and fourteen patients were selected. None ofthe patients had undergone a tooth extraction or bone grafthistory in the previous year. Preoperatively, the patientsunderwent CT scanning to evaluate the Hounsfield unit (HU),and resonance frequency analysis (RFA) was used toevaluate the implant primary stability at the time of implantinstallation. All implants were 4.0 mm diameter and 11.5 mmlength USII. All patients were recorded and the HU andimplant stabil i ty quotient ( ISQ) value were evaluatedaccording to the sites, gender and age.

Results

The highest HU values were found in the mandibular anteriorsite (827.6±151.4), followed by the mandibular molar site(797±135.1), mandibular premolar site (753.8±171.2),maxillary anterior site (726.3±154.4), maxillary premolar site(656.7±173.8) and maxillary molar site (621.5±164.9). TheISQ value was the highest in the mandibular premolar site(81.5±2.4) followed by the mandibular molar site (80.0±5.7),maxillary anterior site (77.4±4.1), mandibular anterior site(76.4±11.9), maxillary premolar site (74.2±14.3) andmaxillary molar site (73.7±7.4).

The mean HU and ISQ value were similar in females andmales. (HU: p=0.331, ISQ: p=0.595) No significant differencewas also found in the age group respectively. However, thecorrelation coefficients between the variables showed aclosed correlation between the HU and ISQ value.

Conclusions Based on these results, the short term clinical These resultsshowed close correlation between the bone density (HU) andprimary stability value (ISQ) at the time of implant installation(Correlation coefficients=0.497, p<0.01).These results strengthen the hypothesis that it might be possibleto predict and quantify the initial implant stability and bone densityfrom a presurgical CT diagnosis.

The Study of Bone Density Assessment on Dental Implant Sites

Fig. 1. References used to measure actual marginal bone loss.a: top level of implant platformb: implant to marginal bone contact levelc: interthread distance of three threads

Fig. 1. Image of transaxial cut of Somatom computed tomography (CT).The hounsfield unit (HU) measurement feature of CT was utilized to evaluatethe bone density.

Table 1. Marginal bone loss around implants according to observation period

DistalMesial t-test P valueTotal

Marginal bone resorption (mm) (Mean ± SD)

Sur-B 0.25±0.48 0.24±0.41 0.24±0.40 .697

B-12 month 0.20±0.50 0.18±0.38 0.19±0.43 .756

Sur-12 month 0.44±0.67 0.42±0.53 0.43±0.56 .439

Sur-B: period from surgery to baseline (functional loading)B-12 month: period from baseline to 12 monthSur-12 month: period from surgery to 12 month post baseline, SD: standard deviation

Table 1. Results of ANOVA for Hounsfield unit (HU) and implant

No ISQHU

Zone 1 14 723.6±154.4 74.4±4.1

Zone 2 14 656.7±173.8 74.2±14.3

Zone 3 23 621.5±164.9 73.7±7.4

Zone 4 8 827.6±151.4 76.4±11.9

Zone 5 12 753.8±171.2 81.5±2.4

Zone 6 43 797.7±135.1 80.0±5.7

p value* 0 0.011

(No: number of patients, Zone 1: maxillary anterior, Zone 2: maxillary premolar, Zone 3:maxillary molar, Zone 4: mandibular anterior, Zone 5: mandibular premolar, Zone 6:mandibular molar, *: p value was taken by ANOVA)

Table 2. Partial correlation coefficients between the variables

HUNo

ISQ (-) 0.497*

HU 0.497* (-)

Age -0.104 -0.125

(HU: Hounsfield unit, ISQ: implant stability quotient, *: p<0.01, adjusted by sex and systemicdiseases)

Table 2. Distribution of implants by bone resorption

Amount of bone resorption (mm) Number of implants

<0.2 40

0.3 10

0.4 3

0.5 9

0.6 5

0.7 3

0.8 2

0.9 1

1 2

1.2 7

1.5 4

2 1

3 1

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ObjectiveThe aim of this study was to evaluate the clinical results ofimplants which were installed with maxillary sinus elevation byusing lateral window technique.

Materials & MethodsWe performed the maxillary sinus elevation by lateral windowtechnique to 87 patients who visited Dept. of Oral &Maxillofacial Surgery, Chonnam National University Hospitalfrom January, 2003 to January, 2007. When the residualbone height was from 3 mm to 7 mm, the sinus elevation andsimultaneous implant installation was mostly performed.When the residual bone height was less than 3 mm, the sinuselevation was performed and the delayed implant installationwas done after 5 or 6 months. No artificial membranes wereused for coverage of the lateral bony window site and freezedried fibrin sealant was applied to the grafted bone. Themean follow-up period was 28.5 months (ranged from 10months to 48 months).

Results 1. Unilateral sinus elevations were performed in 51 patients

and bilateral sinus elevations were performed in 36patients. And the total number of sinus elevationprocedure was 123 cases.

2. The sinus elevation and simultaneous implant installation wasperformed in 89 sinuses and 249 implants were installed. Thesinus elevation and delayed implant installation was performedin 44 sinuses and 141 implants were installed. The totalnumber of implants were 390 in 133 sinuses. The averagehealing period after sinus elevations was 6.1 months indelayed implant installation.

3. Only autogenous bone, autogenous bone mixing withallografts or autogenous bone mixing with xenografts wereused as graft materials.

4. The average period from first surgery to second surgerywas about 7.2 months.

5. Some patients complications, such as perforation of sinusmembrane, swelling, infection and exposure of cover screw.Two implants were removed in the infected sinus.

6. The survival rate of implants with maxillary sinus elevationby lateral window technique was 99.5% and the successrate of implants was 95.1%.

Conclusions These results indicated that the implants which were installedwith maxillary sinus elevation by lateral window techniqueshowed high survival and success rates.

A Retrospective Evaluation of Implant Installation with Maxillary Sinus Augmentation by Lateral Window Technique

Table 1. Survival rates of simultaneously installed implants

Residual boneheight (mm) No. of implant No. of failed

implant Survival rate (%)

> 7 106 2 98.1

7 - 3 132 0 100

< 3 11 0 100

Total 249 2 99.2

Table 2. Survival rates of delayed installed implants

Residual boneheight (mm) No. of implant No. of failed

implant Survival rate (%)

> 7 9 0 100

7 - 3 48 0 100

< 3 84 0 100

Total 141 0 100

The purpose of this study is to evaluate the success rate ofthe Osstem USII (Seoul, Korea) placed in the edentulous areaof type 4 bone quallity.

178 USII implants that had been inserted between 1997 and2005 were followed up for mean 29.4 months. With medicalrecords and radiograghs we analysis the distribution ofpatients' age and gender, position of implant, the kind ofsurgical technique, the type of prostheses, amount of boneresorption survival rate and success rate of implants. Fromthese analysis we got the following results.

In the distribution of implants by site, 167 implants were placedon maxilla and only 11 implants on mandibule. And theresorption of crestal bone more than 1mm was measured atonly 5 implants. The mean plaque, gingival inflammatory andcalculus index were measured 0.56, 0.31, 0.01. The survivalrate was 100% and success rate was 98.8% during 29.4months of mean following up period.

As a result, we got the excellent clinical results of USII implantsystem at bone quallity of type 4.

Multicenter Retrospective Clinical Study of Osstem USII Implant System in Type IV Bone

Table 1. Distribution of operation methods

Operation method No. of implants

Conventional method 54

SL via lateral window 114

SL via osteotome technique 9

GBR 1

Table 2. Distribution of implants by type of prostheses

Prostheses No. of implants

Single 3

Fixed partial 136

Fixed complete 33

Others 6


Amount of bone resorption (mm) No. of implants

None 165

0~0.9 2

1.0~2.0 5

>2.0 0

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In this study, we analyzed data for edentulous patients frommultiple centers after installation of the Osstem USII system ina retrospective study of patient gender, age, implant area,additional surgery, type of prosthesis, and the implant survivaland success rates. We then analyzed the success rate afterprosthetic restoration using implants in completelyedentulous patients to validate the usefulness of the USIIsystem.

Between 1997 and 2005, of the patients who visited regionaldental clinics and private clinics nationwide (Department of Oraland Maxillofacial Surgery, Chosun University Dental College;Department of Oral and Maxillofacial Surgery and dental clinics,Seoul National University Bundang Hospital; Department of Oraland Maxillofacial Surgery, Chonnam University Dental School;dental clinics, Daedong Hospital; All Dental Private Office) andunderwent the Osstem USII system implant procedure, ourmulticenter retrospective study examined 44 completelyedentulous patients (mean age 63.3 years) who received 276implants. The following results were obtained.

1. Eight of the 44 patients had systemic diseases, including 3patients with diabetes, 2 patients with cardiovasculardisease, and 1 patient each with cerebral infarction,hypertension, bronchial asthma, and Parkinson’s disease.

2. The oral hygiene of the 44 patients was classified as good in36 patients, somewhat poor in 7 patients, moderately poor in1 patient, and very poor in 0 patients.

3. Of the implants installed, 80 were 20 mm long, 65 were11.5 mm long, 64 were 13 mm long, and 37 were 15mmlong; 175, 52, and 23 implants had diameters of 4.0, 3.75,and 3.3 mm, respectively.

.4. When opposing teeth were encountered, 60 were natural

teeth, 13 were porcelain, 40 had gold crowns, 7 were resinteeth, 90 were total dentures, and 66 were implant-repaired opposing teeth.

5. After implant installation, no bone resorption of the alveolarcrest occurred in 181 cases, and more than 1 mm of boneloss took place in 44 cases.

6. The mean calculus index for the soft tissues near theimplants in 215 cases was 0.11, and the gum inflammationindex assessed in 226 cases averaged 0.34. The plaqueindex measured in 225 cases averaged 0.55, and thewidth of the attached gingiva measured in 222 casesaveraged 2.05 mm.

7. For implant surgery, no additional surgery was performed in161 cases (58.3%); maxillary sinus elevation via a lateralwindow was performed in 45 cases (16.3%); guided boneregeneration (GBR) was performed in 42 cases (15.2%);simultaneous maxillary sinus elevation and GBR wereperformed in 6 cases (2.1%); and veneer grafting wasperformed in 10 cases (3.6%).

8. According to the implant method, two implants installedwith sinus lifting via a lateral window failed, for a survivalrate of 95.55% (43/45). Temporary complicationsdeveloped with the other procedures, but were resolved inall cases, giving good results.

9. Of the 276 implants installed, two failed and were removedfor a final survival rate of 99.27%.

Multicenter Retrospective Clinical Study of Osstem USII ImplantSystem in Complete Edentulous Patients


Amount of bone resorption (mm) No. of implants

None 181

0~0.9 6

1.0~2.0 35

>2.0 9

Table 2. Survival rate on total implant

Implant statue No. of implants

Survival count 274

Fail count 2

Total 276

Survival (percentage) 99.27%

ObjectiveTo evaluate long-term follow-up clinical performance ofdental implants in use in South Korean populations.

Materials & MethodsA retrospective multicenter cohort study design was used tocol-lect long-term follow-up clinical data from dental recordsof 224 patients treated with 767 2-stage endosseousimplants at Ajou University Medical Center and BundangJesaeng Hospital in South Korea from June 1996 throughDecember 2003. Exposure variables such as gender,systemic disease, location, implant length, implant diameter,prosthesis type, opposing occlusion type, and date ofimplant placement were collected. Outcome variables suchas date of implant failure were measured.

Results Patient ages ranged from 17 to 71.7 years old (mean age,45.6 years old). Implants were more frequently placed in menthan in women (61% versus 39%, or 471 men versus 296women). Systemic disease was described by 9% of thepatients. All implants had hydroxyapatite-blasted surfaces.Most of the implants were 3.75 mm in diameter. Implantlengths 10 mm, 11.5 mm, 13 mm, and 15 mm were usedmost often. Differences of implant survival among differentimplant locations were observed. Implants were used tosupport f ixed partial dentures for the majority of therestorations. The opposing dentition was natural teeth forabout 50% of the implants. A survival rate of 97.9% (751 of767) was observed after 4.5 years (mean, 1.95 ± 1.2 years).

Conclusions Clinical performance of 2-stage dental implantsdemonstrated a high level of predictability. The resultsachieved with a South Korean population did not differ fromresults achieved with diverse ethnic groups (Cohort Study).

Retrospective Multicenter Cohort Study of the Clinical Performance of2-Stage Implants in South Korean Populations

Table 1. Implant Failure and Survival by Year

Year Implants at start ofinterval

Implants lost tofollow-up Failure % of total failure Cumulative failure

1 767 754 13 81.3 98.3

2 754 752 2 12.5 98.0

3 752 751 1 6.2 97.9

4 751 751 0 0 97.9

4.5 751 751 0 0 97.9

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ObjectiveThe aim of the present study was to evaluate the effect ofroughness on the sandblasted with large grit alumina andacid etched surface, which were involved with the in - vivoremoval torque test.

Materials & MethodsThree kinds of implants with different surface topographieswere made by properly changing the blasting and acid-etching processes. This involved changing things like theblasting material, media size, blowing pressure, and acid-etching time. In ten micro-pigs, three submerged implantswere placed in the tibia. Groups were divided into threegroups: RBM (Ra 1.5㎛), Small SA (Ra 1.5㎛) and SA (Ra 2.8㎛). The micro-pigs were sacrificed following a2 and 4 weekhealing period. After 2 and 4 weeks of healing, the micro-pigswere sacrificed and all implants were evaluated by removaltorque testing.

ResultsThere were no statistically significant differences between thegroups. The RBM surface and SA with small roughness (Ra1.5㎛) had relatively similar removal torque values at both 2weeks and 4 weeks, but the SA surface with higherroughness (Ra 2.8㎛) showed a higher removal torque valuethan small Ra SA in 4 weeks (p < .05).

ConclusionThe contribution of macro and micro topography to theanchorage of SA implants was determined. For the SAsurface treatment, the macro-topography with high surfaceroughness is more effective in a removal torque test thanmicro topography in the acid etching process. The SAimplant presented a higher removal torque than the RBMsurface.

The Effects of Surface Roughness on the Sandblasted with Large Grit Alumina and Acid Etched Surface Treatment: In Vivo Evaluation

Fig. 1. The ground sections illustrate the result of healing (original magnification, x 100).

Fig. 2. BIC analysis.

Fig. 3. BA analysis.

Fig. 4. Removal torque measurements.

2weeks

RBM (Ra 1.5㎛) SA (Ra 1.5㎛) SA (Ra 2.5㎛)

4weeks

ObjectiveThis study investigated the bone growth pattern in surgicallycreated coronal defects with various depths around implantsin dogs.

Materials & MethodsFour mongrel dogs were used. All mandibular premolarswere extracted under general anesthesia and left to heal for 2months. After ostectomy, bony defects were prepared in testsites, using a stepped drill with a diameter of 6.3 mm andtwo depths: 2.5 mm (test sites 1 [T1]) and 5.0 mm (test sites2 [T2]). In the control sites, the implants were placed afterostectomy without any coronal defects. T1, T2, and controlsites were prepared in the right and left sides of themandible. Six implants, 3.3 mm in diameter and 10 mm inlength, were placed in each dog; the implants weresubmerged completely.Two dogs were sacrificed 8 weeks after surgery, and theother two dogs were sacrificed 12 weeks after surgery.The stability of all implants was measured with a resonancefrequency analyzer after placement and after sacrifice. Allsites were block-dissected for ground sectioning andhistologic examination.

Results After 12 weeks of healing, only T2 were not filled fully withbone. At week 8, the mean bone-to-implant contact (BIC)was 47.7% for control, 43.6% for T1, and 22.2% for T2. Atweek 12, the control BIC was 56.7% and the 2.5 mm defecthad a greater BIC (58.8%). However, in the 0.5 mm defect,the BIC was 35.1%. At insertion, stability was reduced atsites with a greater defect depth. Similar stability was notedin all specimens after 8 and 12 weeks of healing.

Conclusions Bone healing between an implant and marginal bone wascompromised at sites with a deeper defect when the width ofthe bone defect was 1.5 mm.

Effects of Different Depths of Gap on Healing of Surgically Created Coronal Defects Around Implants in Dogs: A Pilot Study

Fig. 1. Clinical photograph of control, T1, and T2.

Fig. 2. Longitudinal sections after 8 weeks of healing in control (A), T1 (B), and T2 (C) (original magnification×10).

Fig. 3. Longitudinal sections after 12 weeks of healing in control (A), T1 (B), and T2 (C) (original magnification×10).

Table 1. BIC (%; mean ± SD) in the coronal 5 mm of the implant

Table 2. Distance (mm; mean ± SD) from the implant margin to the mostcoronal level of contact between bone and implant

Control Ti (2.5 mm) T2 (5.0 mm)

8 weeks 47.7 ± 14.7 43.6 ± 19.0 22.2 ± 14.7

12 weeks 56.7 ± 17.0 58.8 ± 12.0 35.1 ± 8.0

Table 3. Implant stability quotient values (mean ± SD)


Insertion 72.8 ± 5.2 65.0 ± 9.2 55.3 ± 9.0

8 weeks 79.7 ± 9.2 79.3 ± 2.5 78.1 ± 9.6

12 weeks 74.8 ± 9.0 78.0 ± 6.3 72.0 ± 6.6


8 weeks 0.75 ± 0.26 1.20 ± 0.59 1.98 ± 1.45

12 weeks 0.59 ± 0.36 0.36 ± 0.40 2.52 ± 1.06

A B C

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ObjectiveThe present study was performed to evaluate the effect ofsurface treatment of the cervical area of implant on boneregeneration in fresh extraction socket following implantinstallation.

Materials & MethodsThe four minipigs, 18 months old and 30 kg weighted, wereused. Four premolars of the left side of both the mandibleand maxilla were extracted. ∅3.3 mm and 11.5 mm longUSII Plus implants (Osstem Implant, Korea) with resorbableblasting media (RBM) treated surface and USII implants(Osstem Implant, Korea) with machined surface at the topand RBM surface at lower portion were installed in thesocket. Stability of the implant was measured with OsstellTM

(Model 6 Resonance Frequency Analyser: IntegrationDiagnostics Ltd., Sweden). After 2 months of healing, theprocedures and measurement of implant stability wererepeated in the right side by same method of left side. At fourmonths after first experiment, the animals were sacrificedafter measurement of stability of all implants, and biopsieswere obtained.

ResultsWell healed soft tissue and no mobility of the implants wereobserved in both groups. Histological ly satisfactoryosseointegration of implants was observed with RBMsurface, and no foreign body reaction as well as inflammatoryinf i l trat ion around implant were found. Furthermore,substantial bone formation and high degree ofosseointegration were exhibited at the marginal defectsaround the cervical area of USII Plus implants. However,healing of USII implants was characterized by the incompletebone substitution and the presence of the connective tissuezone between the implant and newly formed bone. Thedistance between the implant platform (P) and the mostcoronal level of bone-to-implant contact (B) after 2 months ofhealing was 2.66 ± 0.11 mm at USII implants group and1.80 ± 0.13 mm at USII Plus implant group. The P-Bdistance after 4 months of healing was 2.29 ± 0.13 mm atUSII implants group and 1.25 ± 0.10 mm at USII plusimplants group. The difference between both groupsregarding the length of P-B distance was statisticallysignificant (p < .05). Concerning the resonance frequencyanalysis (RFA) value, the stability of USII Plus implants groupshowed relatively higher RFA value than USII implants group.

ConclusionsThe current results suggest that implants with rough surfaceat the cervical area have an advantage in process of boneregeneration on defect around implant placed in a freshextraction socket.

The Effect of Surface Treatment of the Cervical Area of Implant onBone Regeneration in Mini-Pig

ObjectiveThis study aimed to investigate whether push-in and pull-outtests measure mechanical properties of the bone-implantinterface differently, and which test is more sensitive tochanges over the healing period.

Materials & MethodsTwo identical self-threading dental implants (∅3.3 x 8.5 mm)were placed in medial surface of the proximal condyles of leftand right tibias of 20 rabbits (40 implants total). Five rabbitseach were sacrificed after 1, 4, 8, and 12 weeks of healing.Push-in test was performed on one side’s tibia implant andpull-out on the other side’s implant, at a rate of 6 mm/min.Primary and secondary implant stabilities and tibia weightwere measured on all implants.

Results The push-in test generated significantly higher failure load (p= .0001; 530 N vs 279 N), lower displacement at failure (p =.0003; 0.436 mm vs 0.680 mm), and higher interfacestiffness (p < .0001; 1,641 N/mm vs 619 N/mm) than pull-outtest. Failure load, stiffness, and secondary implant stabilitywere significantly higher for longer compared with shorterhealing periods, while displacement, tibia weight, and primarystabil ity were not. Fai lure load and stiffness differedsignificantly for four healing times for the push-in but not pull-out test. Failure load was significantly correlated withsecondary implant stability for both push-in (r = 0.66) andpull-out (r = 0.48) tests, but stiffness was significantlycorrelated with secondary stability only for the push-in test (r= 0.72; pull-out test r = 0.40).

ConclusionsThe push-in test appeared more sensitive than pull-out tochanges in mechanical properties at bone-implant interfacesduring healing in rabbit tibia model.

Comparison of Push-in Versus Pull-out Tests on Bone-ImplantInterfaces of Rabbit Tibia Dental Implant Healing Model

Fig. 1. The ground sections illustrate the result of healing. A, The defect adjacent to coronal portion of USII Plus implants is filled with newly

formed bone. B, The defect adjacent to coronal portion of USII implants is separated from the

implant surface by a connective tissue.

Fig. 1. Force-displacement graphs for both pull-out(red: left tibia) and push-in (blue: righttibia) tests for rabbit number 12 from the 12-week healing group.

Fig. 2. Failure load measured by pull-out(black) and push-in(grey) tests, with the differenthealing periods (1- to 12- week).

Fig. 3. Displacement measured at the failure of the bone-implant interface under pull-out(black) and push-in(grey) tests, with the different healing periods (1- to 12- week).

Fig. 4. Stiffness of the bone-implant interface measured by pull-out(black) and push-in(grey)tests, with the different healing periods (1- to 12-week).

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ObjectiveThe aim of the study was to investigate the influence ofcortical bone and increasing implant fixture length on primarystability. Further investigation considered the correlationbetween the presence of cortical bone at the marginal boneand implant stability measured by insertion torque (IT) andresonance frequency analysis (RFA), as well as implantlength, were determined.

Materials & MethodsTwo different types of polyurethane bone models werecompared. (Group1: with cortical and cancellous bone;Group 2: with cancellous bone only). A total of 60 externaltype implants (∅ 4.1, Osstem, USII) with different lengths (7,10, and 13 mm) were used. IT wasrecorded automatically by a computer which was connectedto the Implant fixture installation device during the placement.RFA was conducted to quantify the primary implant stabilityquotient (ISQ). All two measurements were repeated 10 timesfor each group.

Results All these differences were statistically significant between thetwo groups (P < 0.001) and intragroups (P < 0.001). Uponcomparing the IT, cortical bone appears to have a greaterinfluence on implant stability than implant lengths, whereasthe RFA value strongly affects implant length rather than thepresence of the crestal cortical bone.

ConclusionsThe quantitat ive biomechanical evaluations clearlydemonstrated that primary implant stability seems to beinfluenced by the presence of a cortical plate and totalsurface area of the implant fixture appears to be the decisivedeterminant for ISQ value.

Quantatitive Biomechanical Analysis of the Influence of the Cortical Bone and Implant Length on Primary Stability

Fig. 1. Schematic drawing of this experiment.

Fig. 2. Boxplots of maximum insertion torque(left) and ISQ values(right).

Fig. 3. Relationship between implant fixture surface area and insertion torque.

Fig. 1. USII Plus implant(Diameter:4.0mm, Length:13mm).

Fig. 3. Schematic of locations of three temperature sensors.

Fig. 4. Temperature monitoring system: LabView (National Instrument, Texas, US),PXI6259 (National Instrument, Texas, US).

ZirAceAbutment

AcrylicResinBlock

USIIFixture

ObjectiveExcessive heat at the implant-bone interface may compromiseosseointegration. , This study examined heat generated at the implantsurface during preparation of zirconia/alumina complex abutment in vitro.

Material & MethodsSixty zirconia/alumina complex abutments (ZioCera, Osstem, Seoul,Korea) were randomized to twelve experiment groups. The abutmentswere connected to implant (USII, Osstem, Seoul, Korea) and wereembedded in an acrylic-resin block in a 37℃ water bath. Abutmentswere reduced horizontally 1mm height over a period of 1 minute withhighspeed handipiece and polished for 30 seconds with lowspeedhandpiece “with air/water coolant” and “without coolant.” Temperatureswere recorded via thermocouples at the cervical, middle, and apical partof the implant surface. The Mann-Whitney rank-sum test was used toassess the statistical significance of difference of temperature betweenwith coolant and without coolant.

Results 1mm reduction with highspeed handpiece without coolant resulted inmaximum temperature of 41.22℃ at the cervical of implant. 3 of 4temperatures more than 40℃ were observed at the cervical part ofimplant with highspeed handpiece without coolant. Temperaturedifference between “with coolant” and “without coolant” during bothlowspeed polishing and highspeed reduction was statistically significantat the cervix of implant (p = 0.009). In contrast, temperature differencebetween “with coolant” and “without coolant” during both lowspeedpolishing and highspeed reduction was not statistically significant at themiddle and apical part of implant (p > .05).

ConclusionsPreparation of zirconia/alumina complex abutment caused an increase intemperature within the implant but this temperature increase did notreach critical levels described in implant literature.

Heat Transfer to the Implant-Bone Interface During Preparation of Zirconia/Alumina Complex Abutment

Thermocouple : Cervical Area

Thermocouple : Middle Area

Thermocouple : Apex

Fig. 2. ZioCera Abutment (Platform: regular,Height: 5.5mm, collar:5.0mm).

Table 1. Temperatures at each location of implant during preparation of fiveabutments using each handpiece type accompanied with coolant and without coolant

ExperimentGroup

Handpiecetype

Coolant LocationAbutment

1 (℃)Abutment

2 (℃)Abutment

3 (℃)Abutment

4 (℃)Abutment

5 (℃)

1 High Yes Cervical 38.58 37.50 38.90 37.80 38.58

2 High Yes Middle 37.80 37.50 37.02 36.69 37.21

3 High Yes Apical 37.50 37.39 37.02 36.33 37.21

4 High No Cervical 41.22 40.22 38.99 40.10 39.58

5 High No Middle 37.15 38.00 36.98 37.55 37.12

6 High No Apical 37.15 37.69 36.98 37.50 37.01

7 Low Yes Cervical 37.55 37.56 37.89 37.11 37.00

8 Low Yes Middle 37.01 37.00 36.98 37.45 37.69

9 Low Yes Apical 37.01 36.99 36.98 37.45 37.69

10 Low No Cervical 39.33 38.52 39.12 38.20 40.01

11 Low No Middle 37.08 37.96 37.45 37.45 37.23

12 Low No Apical 37.08 37.93 37.40 37.10 37.00

Table 2. Mean temperature and statistical significance of temperature difference forZirconia/Alumina Complex abutment with highspeed contouring

CoolantLocation Mean temperature±SDStatistical

significance (p-value)Yes 38.27±0.59No 40.02±0.83Yes 37.24±0.43No 37.36±0.42Yes 37.09±0.46No 37.27±0.31

Cervical

Middle

Apical

0.009

0.754

0.834

Table 3. Mean temperature and statistical significance of temperature differencefor Zirconia/Alumina Complex abutment with lowspeed polishing

CoolantLocation Mean temperature±SDStatistical

significance (p-value)Yes 37.42±0.36No 39.04±0.71Yes 37.23±0.33No 37.43±0.33Yes 37.22±0.33No 37.30±0.38

Cervical

Middle

Apical

0.009

0.245

0.465

USII PlusAll RBM Surface

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Fig. 1. Mean fatigue life of each implant.

Fig. 2. SEM picture of fractured surface of A, B, C and D implant.

Fig. 3. SEM picture of fracturedsurface of B implant.

Fig. 5. Stress distribution of implant under 600 N loading in 30 angle.

Fig. 4. SEM picture of fracture surface of Babutment screw.

ObjectiveImplant has weak mechanical properties against lateralloading compared to vertical occlusal loading, and therefore,stress analysis of implant fixture depending on its materialand geometric features is needed.

Materials & MethodsTotal 28 of external hexed implants were divided into 7 of 4groups; Group A (3i, FULL OSSEOTITE Implant), Group B(Nobelbiocare, Bra nemark System Mk III Groovy RP), GroupC (Neobiotec, SinusQuickTM EB), Group D (Osstem, USII). Thetype III gold alloy prostheses were fabricated using adequateUCLA gold abutments. Fixture, abutment screw, andabutment were connected and cross-sectioned vertically.Hardness test was conducted using MXT-α. For fatiguefracture test, with MTS 810, the specimens were loaded tothe extent of 60 - 600 N until fracture occurred. The fracturepattern of abutment screw and fixture was observed underscanning electron microscope. A comparative study of stressdistribution and fracture area of abutment screw and fixturewas carried out through finite element analysis.

Results 1. In Vicker’s hardness test of abutment screw, the highest

value was measured in group A and lowest value wasmeasured in group D.

2. In all implant groups, implant fixture fractures occurredmainly at the 3 - 4th fixture thread valley where tensilestress was concentrated. When the fatigue life wascompared, significant difference was found between thegroup A, B, C and D (p < .05).

3. The fracture patterns of group B and group D showedcomplex fai lure type, a fracture behavior includingtransverse and longitudinal failure patterns in both fixtureand abutment screw. In Group A and C, however, thetransverse failure of fixture was only observed.

4. The finite element analysis infers that a fatigue crackstarted at the fixture surface.

Conclusions The maximum tensile stress was found in the implant fixtureat the level of cortical bone. The fatigue fracture occurredwhen the dead space of implant fixture coincides with jigsurface where the maximum tensile stress was generated. Toincrease implant durability, prevention of surrounding boneresorption is important. However, if the bone resorptionprogresses to the level of dead space, the frequency ofimplant fracture would increase. Thus, proper management isneeded.

Fatigue Fracture of Different Dental Implant System Under CyclicLoading

Won-Ju Park, In-Ho ChoJ Kor Acad Prosthodont 2009;47:424-34

Group Manufacturer Implant Type Abutment Abut. screw

A 3i Implant Innovations Inc., FL, USA FULL OSSEOTITE External UCLA Gold Standard ZRTM Gold titeTM

B Novel biocare AB, Goteburg, Sweden Mk III Groovy RP External Gold Adapt Engaging Branemark System RP TorqtiteTM

C Neobiotec Co., Ltd., Seoul, Korea SinusQuickTM EB External Gold UCLA Gold Abutment regular/single Titanium

D Osstem, Seoul, Korea USII External US UCLA Gold Abutment Ebony Gold

1. Jong-Hwa Kim, Young-Kyun Kim, Ji-Hyun Bae. Retrospective clinical study on sinus bone graft and tapered-body implant placement. JKorean Assoc Oral Maxillofac Surg 2013;39:77-84

2. Kwang Chung, Chul-Jung Oh, Ji-Won Ha, Min-Suk Kook, Hong-Ju Park, Hee-Kyun Oh, Su-Gwan Kim, Young-Kyun Kim, Woo-Cheol Kim. Amulticenter clinical study of installed USII Plus / GSII Osstem implants after bone graft. Korean Dental Association. 2012;50(12):743-54

3. Ji-A Moon, Min-Sung Cho, Seung-Gon Jung, Min-Suk Kook, Hong-Ju Park, Hee-Kyun Oh. Retrospective Study of Bone Resorption afterMaxillary Sinus Bone Graft. J Kor Dent Sci. 2011;4(2):59-66


5. Sun-Keun Kim, Jee-Hwan Kim, Keun-Woo Lee, Kyoo-Sung Cho, Dong-Hoo Han. Success Rate and Marginal Bone Loss of Osstem USIIplus Implants; Short term Clinical Study. J Korean Acad Prosthodont 2011;49(3):206-13

6. Su-Won Park, Soo-Mi Jang, Byoung-Hwan Choi, Han-Na Son, Bong-chan Park, Chang-Hwan Kim, Jang-Ho Son, Iel-Yong Sung, Ji-HoLee, Yeong-Cheol Cho. The Study of Bone Density Assessment on Dental Implant Sites. J Korean Assoc Oral Maxillofac Surg2010;36(5):417-22

7. Young-Kyun Kim, Pil-Young Yun, Su-Gwan Kim, Bum-Soo Kim, Joo L Ong. Evaluation of Sinus Bone Resorption and Marginal Bone Lossafter Sinus Bone Grafting and Implant Placement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e21-8

8. Bum-Soo Kim, Young-Kyun Kim, Pil-Young Yun, Yang-Jin Yi, Hyo-Jeong Lee, Su-Gwan Kim, Jun-Sik Son. Evaluation of Peri-implantTissue Response according to the Presence of Keratinized Mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:e24-8

9. Young-Dai Song, Sang-Ho Jun, Jong-Jin Kwon. Correlation Between Bone Quality Evaluated by Cone-Beam Computerized Tomographyand Implant Primary Stability. Int J Oral Maxillofac Implants 2009;24(1):59-64

10. Mi-A Kwon, Yong-Deok Kim, Chang-Mo Jeong, Ju-Youn Lee. Clinical and Radiographic Evaluation of Implants with Dual-microthread: 1-year Study. J Korean Acad Periodontol 2009;39(1):27-36

11. Jang-Ho Son, Byung-hwan Choi, Soo-Won Park, Yeong-Cheol Cho, Iel-Yong Sung, Ji-Ho Lee, Ki-Jung Byun. Bone Density andHistomorphometry Assessment of Dental Implant Using Computerized Tomography. J Korean Assoc Maxillofac Plast Reconstr Surg2009;31(2):137-46

12. Hyun-Joo Kim, Woon-Jung Noh, Seung-Il Song, Sok-Min Ko. Implant Replacement Utilizing Zirconia Abutment in Esthetic Zone. JKorean Implantology(KAOMI) 2009;13(2):16-24



15. Sung-Moon Back, Min-Suk Oh, Su-Kwan Kim. A Retrospective Study on the Clinical Success Rate of Osstem Implant. Key EngineeringMaterials 2008;361-3:1331-4

16. Hong-Ju Park, Min-Suk Kook, Su-Gwan Kim, Young-Kyun Kim, Yong-Seok Cho, Gab-Lim Choi, Young-Hak Oh, Hee-Kyun Oh.Multicenter Retrospective Study of Immediate Two Different RBM Surfaced Implant Systems after Extraction. J Korean AssocMaxillofac Plast Reconstr Surg 2008;30(3):258-65

17. Min-Suk Kook, Hong-Ju Park, Su-Gwan Kim, Young-Kyun Kim, Yong-Seok Cho, Gab-Lim Choi, Young-Hak Oh, Hee-Kyun Oh. ARetrospective Multicenter Clinical Study of Installed USII / SSII Implants after Maxillary Sinus Floor Elevation. J Kor Oral Maxillofac Surg2008;34:341-9


19. Se-Il Ki, Min-Gi Yu, Young-Joon Kim, Min-Suk Kook, Hong-Ju Park, Uttom Kumar Shet, Hee-Kyun Oh. A Retrospective Evaluation ofImplant Installation with Maxillary Sinus Augmentation by Lateral Window Technique. J Korean Assoc Maxillofac Plast Reconstr Surg2008;30(5):457-64

20. Young-Kyun Kim, Pil-Young Yun, Min-Jung Kwon. Short term Retrospective Clinical Study on GSII, SSIII, USIII. J Korean Implantology(KAOMI) 2008;12(2):12-22

21. Kang-Woo Kim, Jae-Kwan Lee, Heung-Sik Um, Beom-Seok Chang. Soft-tissue Management for Primary Closure in Immediate ImplantPlacement. J Korean Acad Periodontol 2008;38(2):253-62


23. Seo-Yoon Kim, Su-Gwan Kim, Hak-Kyun Kim. A Comparision between the Survival Rate of RBM surface implants and Acid-etchedsurface implants : A prospective 1-year Clinical Study. Scientific Poster, J Kor Oral Maxillofac Surg 2008; 34 (Suppl)

Clinical Study

US System References

Crack start (×4000)

Final fracture surface (×2000)

Crack start (×4000)

Final fracture surface (×2000)

Crack propagation direction

Final fracture surface

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24. Uttom Kumar Shet, Min-Suk Kook, Hong-Ju Park, Hee-Kyun Oh. Comparison of Bone Resorption Between Autogenous Bone Graft andDistraction Osteogenesis with Others Treatment Outcome. Scientific Poster, J Kor Oral Maxillofac Surg 2008; 34 (Suppl)

25. Su-Gwan Kim, Chul-Min Park, Young-Kyun Kim, Hee-Kyun Oh, Gab-Lim Choi, Young-Hak Oh. Multicenter Retrospective Clinical Studyof Osstem USII Implant System in Type IV Bone. J Korean Implantology(KAOMI) 2007;11(3):22-9

26. Su-Gwan Kim, Min-Suk Oh, Young-Kyun Kim, Hee-Kyun Oh, Gab-Lim Choi, Young-Hak Oh.Multicenter Retrospective Clinical Study ofOsstem USII Implant System in Complete Edentulous Patients.J Korean Implantology(KAOMI) 2007;11(3):12-21

27. Young-Kyun Kim. Inferior Alveolar Nerve Repositioning and Implant Placement: Case Reports. J Korean Implantology(KAOMI)2007;11(2):42-50

28. Min-Seok Oh, Su-Gwan Kim, Hak-Kyun Kim, Seong-Yong Moon. Restoration of the Mandibular Overdenture Using Osstem Implants.Scientific Poster, 2nd Congress of the ICOI Korea 2007

29. Seok-Min Ko, Jeong-Keun Lee, Steven E. Eckert, Yong-Geun Choi. Retrospective Multicenter Cohort Study of the Clinical Performanceof 2-stage Implants in South Korean Populations. Int J Oral & Maxillofac Implants 2006;21(5):785-8


31. Ju-Rim Sun, Su-Gwan Kim, Hee-Yeon Choi, Jong-Woon Kim, Ho-Bin Lee, Jung-Yeop Park,No-Seung Park, Sang-Yeol Kim, Su-KwonKim, Ki-Pyo No, Young-Hoon Won. USII Implantation Using SimPlant Software in a Maxillary Edentulous Patient; A Case Report. JKorean Implantology(KAOMI) 2006;10(3):28-37


33. Jin-Hwan Kim, Dong-Uk Jung. Vertical Ridge Augmentation and Implant Placement in Severe Bone Loss Area with Autogenous Boneand Bovine Bone. Scientific Poster, 1st Congress of the ICOI Korea 2006

34. Young-Kyun Kim, Jung-Won Hwang, Pil-Young Yun, Su-Gwan Kim, Chae-Heon Chung, Yong-Gun Choi, Sung-Il Song. MulticentricProspective Clinical Study of Korean Implant System: Early Stability Measured by Periotest. J Korean Dent Assoc 2004;42(12): 873-81

35. Ki-Yoon Nam, Beon-Seok Chang, Heung-Sik Um. Retrospective Clinical Study of Domestic Dental Implant Success Rates. J KoreanAcad Periodontol 2003;33(1):37-47

36. Jai-Bong Lee, Young-Soo Wang, Kwang-Ho Shin, Byung-Nam Hwang. Retrospective Multicenter Study of Osstem Endosseous DentalImplant. J Korean Dent Assoc 2000;38(6): 558-66

1. Hong-Young Choi, Jae-June Park, In-Hee Cho, Tae-Kwan Eom. The Effects of Surface Roughness on the Sandblasted with Large GritAlumina and Acid Etched Surface Treatment: In Vivo Evaluation. Scientific Poster, 20th Congress of EAO 2011

2. Min-Suk Kook, Seung-Gon Jung, Kyung-Mi Shim, Seong-Soo Kang, Hong-Ju Park, Sun-Youl Ryu, Hee-Kyun Oh. The Effect of PlateletRich Plasma in Bone Formation on Implant Installation in the Tibia of Beagle Dogs. J Korean Assoc Oral Maxillofac Surg 2010;36:71-7

3. Jee-Hyun Park, Sun-Jung Hwang, Myung-Jin Kim. Effect of rhPDGF-BB and rhBMP-2 on Osseointegration of Titanium Implants atPeriimplant Bone Defects Grafted with Hydroxyapatite: Micro-CT and Histologic Analysis. J Korean Assoc Maxillofac Plast ReconstrSurg 2009;31(6):461-8

4. Ji-Su Oh, Su-Gwan Kim, Sung-Chul Lim, Joo L. Ong. A Comparative Study of Two Noninvasive Techniques to Evaluate Implant Stability:Periotest and Osstell Mentor. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:513-8

5. Hong-Cheol Yoon, Jung-Yoo Choi, Ui-Won Jung, Eun-Kyung Bae, Seong-Ho Choi, Kyoo-Sung Cho, Ho-Yong Lee, Chong-Kwan Kim,June-Sung Shim. Effects of Different Depths of Gap on Healing of Surgically Created Coronal Defects around Implants in Dogs: A PilotStudy. J Periodontol 2008;79(2):355-61

6. Seong-Yong Moon, Su-Gwan Kim, Sung-Chul Lim, Joo L. Ong. Histologic and Histomorphometric Evaluation of Early and ImmediatelyLoaded Implants in the Dog Mandible. J Biomed Mater Res 2008;86A:1122-7

7. Jeong-Wan Ha, Su-Gwan Kim. Histomorphometric Analysis of an Immediate Non-functional Loaded Implant in Dogs. J Korean AssocOral Maxillofac Surg 2008;34:90-4

8. Jin-Yong Cho, Young-Jun Kim, Min-Gi Yu, Min-Suk Kook, Hee-Kyun Oh, Hong-Ju Park. The Effect of Surface Treatment of the CervicalArea of Implant on Bone Regeneration in Mini-pig. J Korean Assoc Oral Maxillofac Surg 2008;34:285-92

9. Soo-Young Bae, Su-Kyoung Kim, Eun-Jung Kang, Young-Bae An, Gyu-Sub Eom, Tae-Gwan Eom. The Effect of Hydroxyapatite-blastedTitanium Surface Roughness on Osteoblast-like Cell Line MG-63. Scientific Poster, Meeting of the Korean Society for Biomaterials 2008


11. Se-Hoon Kahm, Yong-Chul Bae, Sung-Eun Yang, Chang-Hyen Kim, Je-Uk Park. Histomorphometric Analysis of Different TypeImmediate Loaded Implants in Human. Scientific Poster, 16th Congress of EAO 2007

12. Cheong-Hwan Shim, Yu-Jin Jee, Hyun-Chul Song. Expression of Osseointegration-related Genes around Titanium Implant: BMP2,BMP4. J Korean Assoc Maxillofac Plast Reconstr Surg 2005;27(4):307-14

13. Who-Suk Hong, Tae-Hee Kim, Seong-Hee Ryu, Min-Suk Kook, Hong-Ju Park, Hee-Kyun Oh. Comparative Study of Osseointegration of4 Different Surfaced Implants in the Tibia of Dogs. J Korean Assoc Oral Maxillofac Surg 2005;31:46-54

14. Su-Gwan Kim, Cheung-Yeoul Park, Sun-Sik Park, Myung-Duck Kim, Tae-Gwan Eom. Surface Properties of Endosseous Dental Implantsafter Nd;YAG and CO2 Laser Treatment at Various Energies. Scientific Poster, 20th Congress of AO 2005

15. Jae-Woo Kwak, Tae-Hee Kim, Hong-Ju Park, Hee-Kyun Oh. Effect of Implant Surface Characteristics on Osseointegration in the Iliumof Dogs. J Korean Assoc Maxillofac Plast Reconstr Surg 2004;36(6):531-41

16. Tae-Il Kim, Tae-Gwan Eom, Tae-Hee Byun, Kyu-Ok Choi, Jae-Ho Kim. Elemental Analysis of the Surface Residues on Dental Implants.Biomaterials Research 2003;(7)4:254-9


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References


1. Jongrak Hong, Young-Jun Lim, Sang-Oh Park. Quantatitive biomechanical analysis of the influence of the cortical bone and implantlength on primary stability. Clin Oral Impl Res 2013; 23(10): 1193-7

2. Wook-Jin Seong, Shahrzad Grami, Soo-Cheol Jeong, Heather J. Conrad, James S. Hodges. Comparison of Push-in versus Pull-out Testson Bone-Implanr Interfaces of Rabbit Tibia Dental Implant Healing Model. Clin Implant Dent Res 2013;15(3):460-9

3. Ki-Seong Kim, Young-Jun Lim, Myung-Joo Kim, Ho-Beom Kwon, Jae-Ho Yang, Jai-Bong Lee, Soon-Ho Yim. Variation in the TotalLengths of Abutment/Implant Assemblies Generated with a Function of Applied Tightening Torque in External and Internal Implant-Abutment Connection. Clin Oral Impl Res 2011;22:834-9

4. Won-Ju Park, In-Ho Cho. Fatigue Fracture of Different Dental Implant System under Cyclic Loading. J Kor Acad Prosthodont2009;47:424-34

5. Sung-Ae Shin, Chang-Seop Kim, Wook Cho, Chang-Mo Jeong, Young-Chan Jeon, Ji-Hoon Yoon. Mechanical Strength of ZirconiaAbutment in Implant Restoration. J Korean Acad Stomatog Func Occ. 2009;25(4):347-58

6. Jung-Bo Huh, Steven E. Eckert, Seok-Min Ko, Yong-Geun Choi. Heat Transfer to the Implant-Bone Interface during Preparation ofZirconia/Alumina Complex Abutment. Int J Oral Maxillofac Implants 2009;24(4):679-83

7. Ju-Hee Park, Young-Jun Lim, Myung-Joo Kim, Ho-Beom Kwon. The Effect of Various Thread Designs on the Initial Stability of TaperImplants. J Adv. Prosthodont 2009;1:19-25

8. Tae-Gwan Eom, Seung-Woo Suh, Gyeo-Rok Jeon, Jung-Wook Shin, Chang-Mo Jeong. Effect of Tightening Torque on Abutment-FixtureJoint Stability using 3-Dimensional Finite Element Analysis. J Kor Acad Prosthodont 2009;47(2):125-35

9. Myung-Seok Kim, Seong-Joo Heo, Jai-Young Koak, Sung-Kyun Kim. Strains of Abutment and Bones on Implant Overdentures. J KorAcad Prosthodont 2009;47(2):222-31

10. Mi-Soon Lee, Kyu-Won Suh, Jae-Jun Ryu. Screw Joint Stability under Cyclic Loading of Zirconia Implant Abutments. J Kor AcadProsthodont 2009;47(2):164-73


12. Hyon-Mo Shin, Chang-Mo Jeong, Young-Chan Jeon, Mi-Jeong Yun, Ji-Hoon Yoon. Influence of Tightening Torque on Implant-Abutment Screw Joint Stability. J Kor Acad Prosthodont 2008;46(4):396-408


14. Tae-Sik Lee, Jung-Suk Han, Jae-Ho Yang, Jae-Bong Lee, Sung-Hun Kim. The Assessment of Abutment Screw Stability Between theExternal and Internal Hexagonal Joint under Cyclic Loading. J Kor Acad Prosthodont 2008;46(6):561-8

15. Jung-Bo Huh, Sok-Min Ko. The Comparative Study of Thermal Inductive Effect Between Internal Connection and External ConnectionImplant in Abutment Preparation. J Kor Acad Prosthodont 2007;45(1):60-70

16. Dae-Woong Kang, Sang-Wan Shin, Hyun Jung Jo, Sung-Hun Kim. The Effect of Various Designs of Dental Implant Fixtures on TheirInitial Stability. J Korean Implantology(KAOMI) 2007;11(2):32-45

17. In-Ho Kang, Myung-Joo Kim, Young-Jun Lim, Chang-Whe Kim. The Effect of Autoclave Sterilization and Reuse of SmartpegTM‚ on theImplant Stability Quotient (ISQ) Measurement. J Kor Acad Prosthodont 2007;45(5):644-52

18. Si-Yeob Kim, Byung-kook Kim, Jin-Ho Heo, Ju-Youn Lee, Chang-Mo Jeong, Yong-Deok Kim. Evaluation of Stability of Double ThreadedImplant-Emphasis on Initial Stability Using Osstell MentorTM; Part I. J Kor Acad Stomatog Func Occlusion 2007;23(4):327-36

19. Tae-Sik Lee, Jung-Suk Han, Jae-Ho Yang, Jae-Bong Lee, Sung-Hun Kim. An Influence of Abutment Materials on a Screw-Looseningafter Cyclic Loading. J Kor Acad Prosthodont 2007;45(2):240-9

20. Ahran Pae, Kyung-A Jeon, Myung-Rae Kim, Sung-Hun Kim. Comparative Study on The Fracture Strength of Metal-Ceramic VersusComposite Resin-Veneered Metal Crowns in Cement-Retained Implant-Supported Crowns under Vertical Compressive Load. J KorAcad Prosthodont 2007;45(3):295-302

21. Sok-Min Ko. The Accuracy of Impression Technique using the New Impression Coping. Scientific Oral, 12th International College ofProsthodontists Meeting

22. Chae-Heon Chung. Detorque Force of TiN-coating Abutment Screw with Various Coating Thickness After Repeated Closing andOpening. Scientific Oral, 12th International College of Prosthodontists Meeting

23. Min-Gun Kim, Ji-Hun Lee, Dong-Yeol Kim. Simulation of Corrosion Fatigue Life on the Dental Implant. Scientific Oral, Kor Society ofMechanical Engineers Conference, 2007



26. Ki-Duk Park, Sang-Un Han, Hong-Seo Yang, Ju-Seok Kim. Three-Dimensional Finite Analysis of Functional Stresses in Varied Width ofCrestal Bone, Implant Diameter and Buccal off Position. Scientific Poster, 15th Congress of EAO 2006



29. Chun-Yeo Ha, Chang-whe Kim, Young-Jun Lim, Kyung-Soo Jang. The Effect of Internal Implant-Abutment Connection and Diameter onScrew Loosening. J Kor Acad Prosthodont 2005;43(3):379-92

30. Jung Bo Huh, Sok Min Ko. Heat Transfer to the Implant Bone interface During Setting of Autopolymerizing Acrylic Resin Applied toImpression Copings for Implant Impression. J Korean Implantology(KAOMI) 2005;9(2):44-9



33. Ji-Hoon Yoon, Chang-Mo Jeong, Tae-Gwan Eom, Mi-Hyun Cheon. Effect Joint Design on Static and Dynamic Strength. ScientificPoster, 14th Congress of EAO 2005

34. Tae-Hee Byun, Kwang-Hoon Kim. Study on the Adaptation to the Investment Water-Powder Ratio by the Abutment and CastingCrown. Scientific Poster, Kor Dent Technician Associate 2005 Conference

35. Byung-Gi Cho, Jae-Ho Ryu. Study of Possibility Direct Casting on Titanium Abutment. Scientific Poster, Kor Dent Technician Associate2005 Conference

36. Byung-Soo Bae, Jae-Ho Ryu. Investigation of the Resin Adhesion and Task Convenience for Surface Shape. Scientific Poster, Kor DentTechnician Associate 2005 Conference

37. Su-Gwan Kim, T.H. Kang, Kyu-Ok Choi, Tae-Hee Byun, Tae-Gwan Eom, Myung-Duk Kim. Finite Element Stress Analysis according toApical-Coronal Implant Position. Scientific Poster, 19th Congress of AO 2004

38. June-seok Lee,Yung-Soo Kim, Chang-Whe Kim, Jung-Suk Han. Wave Analysis of Implant Screw Loosening using an Air CylindricalCyclic Loading Device. J Prosthet Dent 2002;88:402-8

39. Yong-Tae Jeong, Chae-Heon Chung, Heung-Tae Lee. Screw Joint Stability according to Abutment Screw Materials. J Kor AcadProsthodont 2001;39(3):297-305

40. Soel-Hee Choi, Young-Chan Jeon, Hee-Sung Hwang, Chang-Mo Jeong. Effect of Thin-gold Coating on the Preload and Removal Torqueof Implant Prosthetic Retaining Screw. J Korean Res Soc Dent Mater 2000;27(2):117-27

41. Jae-Bong Lee. Preliminary Study on the Design of Screw Head for Rapid Fastening & Loosening. J Kor Acad Family Medicine2000;2(2):26-31

42. Jae-Bong Lee. The Retrievability of Cementation Type Implant Abutment by Surface Treatments and Types of Cements. J Kor AcadProsthodont 1999;37(5):651-7

43. Jae-Bong Lee, Byung-Nam Hwang, Seung-Hyun Yoo, Chul-Jin Byun, Seok-Kyu Choi. The Comparative Study of Mechnical StabilityBetween Self Tapping Fixture and Double Threaded Fixture by 3-dimensional Finite Element Analysis. J Kor Acad of General Dentistry1999;1(1):73-81


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Table 1. Patients’characteristics (n=69)

Variables The number ofcases (Implants)

0-19

20-29

30-39

40-49

50-59

60-69

70-79

Male

Female

Healthy

Hypertension

Diabetes mellitus

Cerebrovascular attack history

Asthma 2 (6)

Alcoholism 2 (3)

Thyroid disease

No

Yes

Success

Failure

No

Osseointegration failure

Infection

1 (4)

4 (4)

7 (11)

9 (25)

23 (36)

18 (51)

7 (19)

39 (73)

30( 74)

48(98)

10 (19)

8 (15)

2 (9)

2 (6)

2 (3)

1(5)

56 (123)

13 (24)

66 (146)

3 (3)

61 (141)

3 (3)

3 (3)

Age (years)

ObjectiveMini-implant system is applicable to areas of narrow spaceand area requiring temporary loading support. The purposeof this study was to evaluate the clinical outcome of a mini-implant system as well as the application of mini-implantsystem in the dental clinical field.

Materials & MethodsThe patients who had been operated from Jan 2007 to Dec2007 in the four dental facility including Seoul NationalUniversity Bundang Hospital were enrolled. To evaluate thefactors associated with the clinical outcome, the patientswere classified according to gender, age, area of surgery,type of implant, diameter and length of the implant, and thepurpose of the mini-implant system application.

ResultsFrom 147 implants, only three implants failed, one of themwas for temporary loading. There were no serious surgical orprosthetic complications in this study.

Conclusions An analysis of the preliminary data revealed a satisfactoryclinical outcome. However, more long-term evaluation ofnarrow ridge type as well as the patient’s satisfaction on theuse of a provisional type mini-implant system is needed.

Multicentric Retrospective Clinical Study on the Clinical Application of Mini Implant System

ObjectiveThe purpose of this study was to investigate the clinicaleffective of immediate restoration with Osstem MS mini-implant in the edentulous space of 5-6 mm.

Materials & MethodsThe sample consisted of 36 consecutively treated partiallyedentulous patients who had a total of 36 Osstem MS mini-implants, which were 2.5 mm or 3.0 mm in diameter andplaced in 5-6 mm gap. The chair-side-made or laboratory-made provisional crowns for implants were fabricated at thetime of fixtures placed. The final restorations were fabricatedwith gold alloy-fused-porcelain crown 3 to 5 months later.During the mean 21.3 months (12-37 months) follow-up timesince fixtures placement, all implants were examined clinicallyand radiologically.

Results No implant failed before restoration. One implant led anadjacent tooth pulp necrosis after the implantation, but thenatural tooth and implant were successfully retained by rootcanal therapy. 36 implants in 36 patients who were followed-up were successful and their aesthetic results weresatisfactory.

Conclusions Immediate loaded implant with Osstem MS mini-implant hasgood clinical prosthetic effects in the edentulous space of 5-6mm.

Clinical Research of Immediate Restoration Implant with Mini-Implants in Edentulous Space

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Gender

Medical history

Smoking

Results

Complications

Fig. 1. Immediate restoration implant with mini-implant of case 1.



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MS System References

1. Kyo-Jin Ahn, Young-Kyun Kim, Pil-Young Yun, Yang-Jin Yi. Overdenture using MS Port mini-implants: A case report. J Korean CilnicalImplant 2012;32(2):123-30

2. Yong-Jin Kim, Young-Jin Park, Kyung-Tae Park. Mandibular anterior single tooth replacement using the MS implant system. ScientificPoster, Osstem Meeting 2013

3. Young-Kyun Kim, In-Sung Yeo, Yang-Jin Yi, Un-Kyu Kim, Kyung-Nam Moon, Seung-Joon Jeon, Yong-Seok Cho, Pil-Young Yun.Multicentric Retrospective Clinical Study on the Clinical Application of Mini Implant System. J Korean Assoc Oral Maxillofac Surg2010;36(4):325-30

4. Huang JS, Zhao JJ, Liu Q, Liu TT. Clinical Research of Immediate Restoration Implant with Mini-implants in Edentulous Space. Hua XiKou Qiang Yi Xue Za Zhi. 2010 Aug;28(4):412-6

78

The “OSSTEM IMPLANT Research Project”for the promotionof implantology may support clinical and laboratory researchat the discretion of its research committee.

Further information concerning conditions can be obtained from thefollowing address:

Clinical Oriented Research Team for Implantology

Implant R&D Center of OSSTEM IMPLANT Co., Ltd.

#38-44, Geoje 3-dong, Yeonje-gu, Busan, Korea. Zip. 611-801

Tel. 82-70-7016-4745

Fax. 82-70-4394-0404

[email protected]

http://www.osstem.com

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